Healthcare Provider Details
I. General information
NPI: 1306973680
Provider Name (Legal Business Name): CAPITOL SURGERY, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 02/27/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
514 SAINT PETER ST SUITE 220
SAINT PAUL MN
55102-1001
US
IV. Provider business mailing address
514 SAINT PETER ST SUITE 220
SAINT PAUL MN
55102-1001
US
V. Phone/Fax
- Phone: 651-294-3950
- Fax: 651-287-8782
- Phone: 651-294-3950
- Fax: 651-287-8782
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 302F00000X |
| Taxonomy | Exclusive Provider Organization |
| License Number | 39600 |
| License Number State | MN |
VIII. Authorized Official
Name:
BARBARA
SCHMIDT
STEINBRUNN
Title or Position: PRESIDENT
Credential: MD
Phone: 651-294-3950