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General NPI Number Information
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NPI Number | 1801739990
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Entity Type | Organization
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Legal Business Name | NORTH STAR INSTITUTE FOR DIGESTIVE SURGERY PLLC
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Dates
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Enumeration Date | 04/13/2026
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Last Update Date | 07/30/2026
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Provider Practice Location Address
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Address Line | 1801 19TH AVE SW
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City | WILLMAR
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State | MN
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Zip | 56201-4946
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Country | US
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Telephone | 320-212-3579
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Fax |
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Provider Business Mailing Address
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Address Line | 1801 19TH AVE SW
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City | WILLMAR
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State | MN
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Zip | 56201-4946
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Country | US
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Telephone | 320-263-4321
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ROBERT G JOHNSON
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Credential | MD
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Telephone | 320-212-3579
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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 |
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License Number State | NULL
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