Organization Name: | INFECTIOUS DISEASE CONSULTANTS PA |
NPI Number: | 1003949892 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DANIEL JOEL ANDERSON (PRESIDENT) |
Mailing Address: | 11676 Wayzata Blvd Minnetonka |
State: | MN US |
Postal Code: | 553052009 |
Phone Number: | 9527468360 |
Fax Number: | 9527468368 |
NPI Enumeration Date: | 03/13/2007 |
NPI Last Update Date: | 07/23/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 1201 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MN |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |