Organization Name: | LANDIS PLASTIC SURGERY P C |
NPI Number: | 1265509350 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KAREN ENGEN (ADMINISTRATOR) |
Mailing Address: | 109 Bushaway Rd Suite 200 Wayzata |
State: | MN US |
Postal Code: | 553911945 |
Phone Number: | 7635518985 |
Fax Number: | 7635514897 |
NPI Enumeration Date: | 11/30/2006 |
NPI Last Update Date: | 02/15/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2086S0122X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Surgery |
Taxonomy Specialization: | Plastic and Reconstructive Surgery |
Taxonomy Definition: | A surgeon who specializes in plastic and reconstructive surgery. |