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General NPI Number Information
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NPI Number | 1306025275
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Entity Type | Organization
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Legal Business Name | MINNESOTA GYNECOLOGY & SURGERY
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Dates
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Enumeration Date | 10/29/2007
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Last Update Date | 10/29/2007
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Provider Practice Location Address
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Address Line | 7450 FRANCE AVE S SUITE 240
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City | EDINA
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State | MN
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Zip | 55435-4787
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Country | US
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Telephone | 952-893-9100
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Fax | 952-893-9105
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Provider Business Mailing Address
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Address Line | 7450 FRANCE AVE S SUITE 240
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City | EDINA
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State | MN
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Zip | 55435-4787
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Country | US
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Telephone | 952-893-9100
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Fax | 952-893-9105
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWARD MICHAEL BEADLE
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Credential | M.D.
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Telephone | 952-893-9100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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