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General NPI Number Information
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NPI Number | 1457438442
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Entity Type | Organization
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Legal Business Name | METROPOLITAN SURGICAL ASSOCIATES, P.A.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3366 OAKDALE AVE N SUITE 506
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City | MINNEAPOLIS
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State | MN
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Zip | 55422-2948
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Country | US
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Telephone | 763-520-1230
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Fax | 763-520-1282
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Provider Business Mailing Address
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Address Line | 3366 OAKDALE AVE N SUITE 506
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City | MINNEAPOLIS
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State | MN
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Zip | 55422-2948
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Country | US
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Telephone | 763-520-1230
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Fax | 763-520-1282
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Authorized Official
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Title or Position | TREASURER
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Name | NATHAN M NOZNESKY
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Credential | M.D.
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Telephone | 763-520-1230
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 763
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License Number State | MN
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