Provider Demographics
NPI:1306025275
Name:MINNESOTA GYNECOLOGY & SURGERY
Entity Type:Organization
Organization Name:MINNESOTA GYNECOLOGY & SURGERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BEADLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:952-893-9100
Mailing Address - Street 1:7450 FRANCE AVE S
Mailing Address - Street 2:SUITE 240
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4787
Mailing Address - Country:US
Mailing Address - Phone:952-893-9100
Mailing Address - Fax:952-893-9105
Practice Address - Street 1:7450 FRANCE AVE S
Practice Address - Street 2:SUITE 240
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4787
Practice Address - Country:US
Practice Address - Phone:952-893-9100
Practice Address - Fax:952-893-9105
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty