Grootwassink, Wesley Robert

Grootwassink, Wesley Robert is an individual health care provider with primary practice located at 14001 Ridgedale Dr Ste 200, Minnetonka MN 55305-1753. He recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as his primary health care specialty. Grootwassink, Wesley Robert can be contacted via phone (952) 249-2000.

Contact Information

Primary practice address
14001 Ridgedale Dr Ste 200 Minnetonka MN 55305-1753
Phone: (952) 249-2000
Fax: (952) 249-2099
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 36153 Minnesota

Profile Details

NPI number 1952307639
LBN Legal business name Grootwassink, Wesley Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 27th, 2005
Last updated May 30th, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1952307639 NPPES
Minnesota MEDICAID 172828800

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