RUSSELL L WAVRIN MD NPI 1962479071

NPI Information

NPI: 1962479071
Provider Name: RUSSELL L WAVRIN, MD
Classification: Obstetrics & Gynecology - 207V00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
6545 FRANCE AVE S
STE 540
EDINA, MN
ZIP 55435
Phone: (952) 927-4045
Get Directions

Russell L Wavrin, MD is an obstetrics gynecology in Edina, MN. The provider is an obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. Russell L Wavrin, MD NPI is 1962479071. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

6545 FRANCE AVE S
STE 540
EDINA, MN
ZIP 55435-131
Phone: (952) 927-4045
Fax: (952) 924-4133

The NPI 1962479071 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/7/2006 and was last updated on 4/4/2016.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207VE0102X	Obstetrics & Gynecology	Reproductive Endocrinology	244196	MINNESOTA	No
2	207V00000X	Obstetrics & Gynecology		244196	MINNESOTA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	B58384	MEDICARE UPIN
2	HP14652	OTHER	MINNESOTA	HEALTHPARTNERS
3	160000055	MEDICARE ID-TYPE UNSPECIFIED
4	055302600	MEDICAID	MINNESOTA
5	18559WA	OTHER	MINNESOTA	BCBS

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

NPI Synchronization or Removal

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