Provider Demographics
NPI:1073621850
Name:REGIONAL ANESTHESIA SERVICES PA
Entity Type:Organization
Organization Name:REGIONAL ANESTHESIA SERVICES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:K
Authorized Official - Last Name:YUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:952-932-0998
Mailing Address - Street 1:13911 RIDGEDALE DR
Mailing Address - Street 2:SUITE 350
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1771
Mailing Address - Country:US
Mailing Address - Phone:952-932-9012
Mailing Address - Fax:952-932-7122
Practice Address - Street 1:13911 RIDGEDALE DR
Practice Address - Street 2:SUITE 350
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1771
Practice Address - Country:US
Practice Address - Phone:952-932-9012
Practice Address - Fax:952-932-7122
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN27352REOtherBLUE SHIELD
MNC01394Medicare ID - Type Unspecified