Theodore Adolph Groskreutz MD

NPI 1982703948 - Family Medicine - 207Q00000X

NPI Details
NPI 1982703948
Gender Male
Enumeration Date 09/22/2006
Last Updated 10/13/2011
Entity Type Individual
Active Over 10 years ago
Practice Location
111 HUNDERTMARK RD
212 MEDICAL CENTER STE 220
CHASKA MN, 55318-4551, US
Phone (952) 448-2050
Fax
Business Location
2925 CHICAGO AVE
MINNEAPOLIS MN, 55407-1321, US
Phone (612) 262-5000
Fax
Toxanomy
Taxonomy Code 207Q00000X
License State Minnesota
License Number 21831
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According to our database, Theodore Adolph Groskreutz MD NPI is 1982703948, taxonomy code is 207Q00000X and license number is 21831, license state is located at Minnesota. Theodore Adolph Groskreutz MD physically located at 111 Hundertmark Rd, Chaska MN, 55318-4551. NPI Number Theodore Adolph Groskreutz MD has the Individual type.

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1982703948 NPI number is provided on an as is basis without warranty of any kind. 1982703948 is maintained by the National Plan & Provider Enumeration System. The contents of Theodore Adolph Groskreutz MD are for informational purposes only.