Provider Demographics
NPI:1417605056
Name:MINKIN SURGICAL LLC
Entity type:Organization
Organization Name:MINKIN SURGICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DARIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MINKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:314-229-2802
Mailing Address - Street 1:1211 DEVONWORTH DR
Mailing Address - Street 2:
Mailing Address - City:TOWN AND COUNTRY
Mailing Address - State:MO
Mailing Address - Zip Code:63017-8448
Mailing Address - Country:US
Mailing Address - Phone:314-229-2802
Mailing Address - Fax:314-965-8756
Practice Address - Street 1:2355 DOUGHERTY FERRY RD STE 430
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63122-3325
Practice Address - Country:US
Practice Address - Phone:314-965-8410
Practice Address - Fax:314-965-8756
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty