Provider Demographics
NPI:1477519130
Name:SURGICARE OF MINNEAPOLIS LTD
Entity Type:Organization
Organization Name:SURGICARE OF MINNEAPOLIS LTD
Other - Org Name:SURGICAL SPECIALTY CENTER OF MINNESOTA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF ADMINISTRATIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:VOIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:952-832-9360
Mailing Address - Street 1:6099 WAYZATA BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5538
Mailing Address - Country:US
Mailing Address - Phone:952-832-9360
Mailing Address - Fax:
Practice Address - Street 1:6099 WAYZATA BLVD STE 300
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-5538
Practice Address - Country:US
Practice Address - Phone:952-832-9360
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-21
Last Update Date:2022-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN490000011Medicare PIN