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General NPI Number Information
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NPI Number | 1235274093
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Entity Type | Organization
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Legal Business Name | METROPOLITAN UROLOGIC SPECIALISTS. P.A.
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 12/16/2009
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Provider Practice Location Address
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Address Line | 360 SHERMAN ST SUITE 400
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City | SAINT PAUL
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State | MN
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Zip | 55102-2564
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Country | US
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Telephone | 651-999-7037
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Fax |
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Provider Business Mailing Address
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Address Line | 2550 UNIVERSITY AVE W SUITE 240N
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City | SAINT PAUL
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State | MN
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Zip | 55114-1052
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Country | US
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Telephone | 651-999-7037
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Fax |
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Authorized Official
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Title or Position | UROLOGIST, PRESIDENT
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Name | CHRISTOPHER J KNOEDLER
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Credential | M.D.
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Telephone | 651-999-7037
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 1 203BU0100Y
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License Number State | MN
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