Provider Demographics
NPI:1275553117
Name:ROISELAND, ALAN J (MD)
Entity Type:Individual
Prefix:
First Name:ALAN
Middle Name:J
Last Name:ROISELAND
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:502 2ND ST SW
Mailing Address - Street 2:SUITE 1
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-3365
Mailing Address - Country:US
Mailing Address - Phone:320-235-7232
Mailing Address - Fax:320-231-8609
Practice Address - Street 1:502 2ND ST SW
Practice Address - Street 2:SUITE 1
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-3365
Practice Address - Country:US
Practice Address - Phone:320-235-7232
Practice Address - Fax:320-231-8609
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2014-01-22
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Provider Licenses
StateLicense IDTaxonomies
MN44600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN325101845OtherPRIME WEST
MN113M7R0OtherBLUE CROSS BLUE SHIELD
MN141943OtherUCARE
MN260445100Medicaid
MN080183506OtherRR MEDICARE
MN1670840OtherARAZ
MNMR1081031509OtherPREFERRED ONE
MNHP35565OtherHEALTH PARTNERS
FM01-09641OtherMEDICA
MN260445100Medicaid
MN325101845OtherPRIME WEST