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NPI Code Detail

MEDICARE: SUMMIT ORTHOPEDICS, LTD

MEDICARE: SUMMIT ORTHOPEDICS, LTD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery Physician

General Provider Information

NPI Number : 1609927169
Entity Type Code : Organization
Provider Name (Legal Business Name) : SUMMIT ORTHOPEDICS, LTD
Provider Business Mailing Address
First Line : 710 COMMERCE DR STE 200
Second Line :
City : WOODBURY
State : MN
Zip : 55125-4925
Country : US
Telephone Number : 651-968-5042
Fax Number : 651-968-5904
Provider Business Practice Location Address
First Line : 146 LAKE ST N
Second Line :
City : FOREST LAKE
State : MN
Zip : 55025-2518
Country : US
Telephone Number : 651-968-5200
Fax Number :
Authorized Official
Title or Position : CFO
Name : JOHN BIEN
Credential :
Telephone Number : 651-968-5870
Provider Enumeration Date : 01/12/2007
Last Update Date : 05/10/2018

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Directions to “SUMMIT ORTHOPEDICS, LTD ” Practice Location

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