Provider Demographics
NPI:1306973680
Name:CAPITOL SURGERY, PLLC
Entity type:Organization
Organization Name:CAPITOL SURGERY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:SCHMIDT
Authorized Official - Last Name:STEINBRUNN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:651-294-3950
Mailing Address - Street 1:514 SAINT PETER ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-1001
Mailing Address - Country:US
Mailing Address - Phone:651-294-3950
Mailing Address - Fax:651-287-8782
Practice Address - Street 1:514 SAINT PETER ST
Practice Address - Street 2:SUITE 220
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-1001
Practice Address - Country:US
Practice Address - Phone:651-294-3950
Practice Address - Fax:651-287-8782
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN39600302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNS96042Medicare UPIN
PENDINGMedicare ID - Type Unspecified