Provider Demographics
NPI:1780625491
Name:TWIN CITIES NEUROSURGERY,PLLC
Entity type:Organization
Organization Name:TWIN CITIES NEUROSURGERY,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:BERTON
Authorized Official - Last Name:AHLBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:763-427-8547
Mailing Address - Street 1:4440 TYROL CRST
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55416-3554
Mailing Address - Country:US
Mailing Address - Phone:763-427-8547
Mailing Address - Fax:763-576-5394
Practice Address - Street 1:4440 TYROL CRST
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55416-3554
Practice Address - Country:US
Practice Address - Phone:763-427-8547
Practice Address - Fax:763-576-5394
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1682207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty