Provider Demographics
NPI:1144077587
Name:ACCESS SURGICAL
Entity type:Organization
Organization Name:ACCESS SURGICAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:ERNEST
Authorized Official - Last Name:CHUPP
Authorized Official - Suffix:
Authorized Official - Credentials:MD FACS
Authorized Official - Phone:402-681-1676
Mailing Address - Street 1:2740 HUNTINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-3918
Mailing Address - Country:US
Mailing Address - Phone:402-681-1676
Mailing Address - Fax:
Practice Address - Street 1:2740 HUNTINGTON AVE
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-3918
Practice Address - Country:US
Practice Address - Phone:402-681-1676
Practice Address - Fax:952-213-8458
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty