Provider Demographics
NPI:1427043512
Name:PARTIDA RUESSGA, FERNANDO J (MD)
Entity Type:Individual
Prefix:
First Name:FERNANDO
Middle Name:J
Last Name:PARTIDA RUESSGA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:8055 173RD ST W
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-9541
Mailing Address - Country:US
Mailing Address - Phone:952-985-5258
Mailing Address - Fax:952-431-9651
Practice Address - Street 1:14135 CEDAR AVE
Practice Address - Street 2:STE 300
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-4522
Practice Address - Country:US
Practice Address - Phone:952-431-9655
Practice Address - Fax:952-431-9651
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2009-03-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN028626208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
D80143Medicare UPIN