Provider Demographics
NPI:1447221361
Name:TWITO, RANDY S (MD)
Entity Type:Individual
Prefix:
First Name:RANDY
Middle Name:S
Last Name:TWITO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:MS21110Q
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:952-883-5375
Mailing Address - Fax:651-254-8379
Practice Address - Street 1:435 PHALEN BLVD
Practice Address - Street 2:HEALTHPARTNERS SPECIALITY CENTER 435
Practice Address - City:ST. PAUL
Practice Address - State:MN
Practice Address - Zip Code:55130-5302
Practice Address - Country:US
Practice Address - Phone:651-254-8300
Practice Address - Fax:651-254-8379
Is Sole Proprietor?:No
Enumeration Date:2006-01-30
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN28016207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN648288100Medicaid
MND49020Medicare UPIN
MN200000433Medicare ID - Type Unspecified