Healthcare Provider Details

I. General information

NPI: 1477519130
Provider Name (Legal Business Name): SURGICARE OF MINNEAPOLIS LTD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 08/08/2022
Certification Date: 08/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6099 WAYZATA BLVD STE 300
ST LOUIS PARK MN
55416-5538
US

IV. Provider business mailing address

6099 WAYZATA BLVD STE 300
ST LOUIS PARK MN
55416-5538
US

V. Phone/Fax

Practice location:
  • Phone: 952-832-9360
  • Fax:
Mailing address:
  • Phone: 952-832-9360
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TERRY VOIGHT
Title or Position: CHIEF ADMINISTRATIVE OFFICER
Credential:
Phone: 952-832-9360