Provider Demographics
NPI:1912971912
Name:MINNESOTA UROLOGY, PA
Entity Type:Organization
Organization Name:MINNESOTA UROLOGY, PA
Other - Org Name:METRO UROLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:UROLOGIST, PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:J
Authorized Official - Last Name:MILBANK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:651-999-7037
Mailing Address - Street 1:6025 LAKE RD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WOODBURY
Mailing Address - State:MN
Mailing Address - Zip Code:55125-1712
Mailing Address - Country:US
Mailing Address - Phone:651-999-6800
Mailing Address - Fax:651-999-6830
Practice Address - Street 1:6025 LAKE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:WOODBURY
Practice Address - State:MN
Practice Address - Zip Code:55125-1712
Practice Address - Country:US
Practice Address - Phone:651-999-6800
Practice Address - Fax:651-999-6830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Multi-Specialty
No207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNCP2429OtherMEDICARE RAILROAD
MN919208500Medicaid
WI000049025Medicare ID - Type UnspecifiedGROUP ID
MNC00559Medicare ID - Type UnspecifiedGROUP ID
WI000056010Medicare PIN
MN0252990001Medicare NSC