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General NPI Number Information
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NPI Number | 1013004175
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Entity Type | Organization
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Legal Business Name | MIDWEST PLASTIC SURGERY, P.A.
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Dates
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Enumeration Date | 10/09/2006
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Last Update Date | 07/10/2009
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Provider Practice Location Address
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Address Line | 6545 FRANCE AVE S STE 350
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City | EDINA
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State | MN
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Zip | 55435-2120
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Country | US
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Telephone | 952-920-2600
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Fax | 952-920-2668
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Provider Business Mailing Address
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Address Line | 6545 FRANCE AVE S STE 350
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City | EDINA
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State | MN
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Zip | 55435-2120
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Country | US
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Telephone | 952-920-2600
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Fax | 952-920-2668
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. DAVID F RUEBECK
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Credential | MEDICAL DOCTOR
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Telephone | 952-920-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 1389
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License Number State | MN
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