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EAR NOSE & THROAT SPECIALTY CARE OF MINNESOTA PA NPI 1336175744


NPI Information

NPI: 1336175744
Provider Name: EAR NOSE & THROAT SPECIALTY CARE OF MINNESOTA PA

Doing Business As: ENT SPECIALTY CARE

Classification: Otolaryngology - 207Y00000X
Entity Type: Organization

CLIA Number: 24D2281084

Address:
6099 WAYZATA BLVD STE 200
ST LOUIS PARK, MN
ZIP 55416
Phone: (612) 871-1144
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EAR NOSE & THROAT SPECIALTY CARE OF MINNESOTA PA is an otolaryngology in St Louis Park, MN. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. EAR NOSE & THROAT SPECIALTY CARE OF MINNESOTA PA NPI is 1336175744. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Ent Specialty Care.

The provider's business location address is:

6099 WAYZATA BLVD STE 200
ST LOUIS PARK, MN
ZIP 55416-538
Phone: (612) 871-1144
Fax: (612) 871-2012

The provider's authorized official is Marcy Jablonski .
The authorized official title is Business Office Manager and has the following contact phone number (952) 236-1692.

The CLIA number assigned to this NPI record is 24D2281084 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/25/2006 and was last updated on 4/26/2023.


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
1207Y00000XOtolaryngologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1234810100MEDICAIDMINNESOTA

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.