NPI 1104252022

Bashioum Cosmetic Surgery Center, LTD.

Organisation Plastic Surgery Physician Wayzata, MN

Practice location

Address: 445 Lake St E STE 210, Wayzata, MN 55391-1671
Phone: (952) 449-4900
Fax: (952) 449-9531
Mailing address: 2854 Highway 55 Suite 130, Eagan, MN 55121-2156

Authorised official

Name: Ralph W Bashioum
Title: President
Phone: (952) 449-4900

Registered specialties

Plastic Surgery Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208200000X

Other Plastic Surgery providers in Minnesota →

Registry record

NPI: 1104252022
Entity type: Organization
NPI issued: 24 Sep 2013
Record last updated: 16 Jan 2014

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.