Provider Demographics
NPI:1508086463
Name:UHDE, THOMAS FREDRICK (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:FREDRICK
Last Name:UHDE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1228 30TH ST NW # S102
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-4131
Mailing Address - Country:US
Mailing Address - Phone:701-400-8898
Mailing Address - Fax:
Practice Address - Street 1:3101 N 11TH ST
Practice Address - Street 2:
Practice Address - City:BISMARCK
Practice Address - State:ND
Practice Address - Zip Code:58503-0594
Practice Address - Country:US
Practice Address - Phone:701-224-9521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND4957183500000X
MN118372183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist