| Doctor Name: | DERIK T. WELDON |
| NPI Number: | 1093924375 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 35100 |
| Business Practice Address: | 166 19th Street South Suite 100 Sartell, MN - 563772154 |
| Business Phone Number: | 3202510609 |
| Business Fax Number: | 3202513806 |
| Mailing Address: | Po Box 1450 Nw 6035, MINNEAPOLIS |
| State: | MN |
| Postal Code: | 554856035 |
| Phone Number: | 8006344064 |
| Fax Number: | 9525136880 |
| NPI Enumeration Date: | 05/22/2007 |
| NPI Last Update Date: | 12/11/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | 35100 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |