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General NPI Number Information
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NPI Number | 1275762957
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Entity Type | Organization
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Legal Business Name | CENTRAL MINNESOTA SURGICAL CENTER, LLC
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Dates
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Enumeration Date | 07/02/2009
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Last Update Date | 10/06/2009
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Provider Practice Location Address
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Address Line | 2000 23RD ST S STE 305
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City | SARTELL
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State | MN
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Zip | 56377
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Country | US
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Telephone | 320-229-7955
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Fax | 320-229-7901
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Provider Business Mailing Address
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Address Line | 2000 23RD ST S STE 305
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City | SARTELL
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State | MN
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Zip | 56377
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Country | US
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Telephone | 320-229-7955
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Fax | 320-229-7901
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Authorized Official
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Title or Position | CHIEF MANAGER/MEDICAL DIRECTOR
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Name | DR. MITCHELL V GOSSMAN
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Credential | M.D.
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Telephone | 320-253-3637
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QA1903X
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Taxonomy Name | Ambulatory Surgical Clinic/Center
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License Number |
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License Number State |
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