Organization · Type 2 NPI
Aesthetic and Plastic Surgery, PA
Plastic and Reconstructive Surgery Physician · Maple Grove, MN
NPI number
1871704338
Active
Practice location
12000 Elm Creek Blvd N Ste 301
Maple Grove, MN 55369-7090
Fax (763) 236-9010
Mailing address
11850 Blackfoot St NW Ste 130
Coon Rapids, MN 55433-2583
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Plastic and Reconstructive Surgery Physician Primary | 2086S0122X | 1585 (MN) |
Plastic and Reconstructive Surgery Physician: A surgeon who specializes in plastic and reconstructive surgery.
Another provider at this address
About NPI 1871704338
Aesthetic and Plastic Surgery, PA's National Provider Identifier is 1871704338, issued on May 25, 2007. The primary taxonomy on file is Plastic and Reconstructive Surgery Physician (2086S0122X), and the practice location is in Maple Grove, MN. The record was last updated on Feb 26, 2026.