Peter E Dyrud, | |
6500 Excelsior Blvd, St Louis Park, MN 55426-4702 | |
(952) 993-3246 | |
Not Available |
Full Name | Peter E Dyrud |
---|---|
Gender | Male |
Speciality | Thoracic Surgery (cardiothoracic Vascular Surgery) |
Location | 6500 Excelsior Blvd, St Louis Park, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1831174382 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208G00000X | Thoracic Surgery (cardiothoracic Vascular Surgery) | 28696 (Minnesota) | Primary |
Entity Name | Park Nicollet Clinic |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1780621904 PECOS PAC ID: 7911819438 Enrollment ID: O20031104000046 |
Mailing Address | Practice Location Address |
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Peter E Dyrud, 6465 Wayzata Blvd, Suite 315, St Louis Park, MN 55426-1728 Ph: () - | Peter E Dyrud, 6500 Excelsior Blvd, St Louis Park, MN 55426-4702 Ph: (952) 993-3246 |
Bernard Harrison, MD Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 6500 Excelsior Blvd, St Louis Park, MN 55426 Phone: 952-993-3246 | |
Dr. Christopher Timothy Holley, M.D. Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 6500 Excelsior Blvd, St Louis Park, MN 55426 Phone: 952-993-3246 | |
Dr. Andrew Philip Rabenstein, M.D. Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Medicare Enrolled Practice Location: 6500 Excelsior Blvd, St Louis Park, MN 55426 Phone: 952-993-3246 | |
Ramoncito A David, Thoracic Surgery (Cardiothoracic Vascular Surgery) Medicare: Accepting Medicare Assignments Practice Location: 6500 Excelsior Blvd, St Louis Park, MN 55426 Phone: 952-993-3010 |