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WAYZATA CHILDREN'S CLINIC P.A. NPI 1023081577


NPI Information

NPI: 1023081577
Provider Name: WAYZATA CHILDREN'S CLINIC P.A.
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 24D0400933

Address:
14001 RIDGEDALE DR
#100
MINNETONKA, MN
ZIP 55305
Phone: (952) 473-0211
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WAYZATA CHILDREN'S CLINIC P.A. is a pediatrics in Minnetonka, MN. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. WAYZATA CHILDREN'S CLINIC P.A. NPI is 1023081577. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

14001 RIDGEDALE DR
#100
MINNETONKA, MN
ZIP 55305-753
Phone: (952) 473-0211
Fax: (952) 473-7908

The provider's authorized official is Martha R. Engelbrekt .
The authorized official title is President and has the following contact phone number (952) 473-0211.

The CLIA number assigned to this NPI record is 24D0400933 - physician office with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 2/7/2006 and was last updated on 4/5/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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