Provider Demographics
NPI:1659027746
Name:BRONSDON, MATTHEW WHITEHOUSE (PA-C)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:WHITEHOUSE
Last Name:BRONSDON
Suffix:
Gender:M
Credentials:PA-C
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Mailing Address - Street 1:4200 DAHLBERG DR STE 300
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-4841
Mailing Address - Country:US
Mailing Address - Phone:952-512-5600
Mailing Address - Fax:
Practice Address - Street 1:8540 QUADAY AVE NE
Practice Address - Street 2:
Practice Address - City:OTSEGO
Practice Address - State:MN
Practice Address - Zip Code:55330-6522
Practice Address - Country:US
Practice Address - Phone:763-441-0298
Practice Address - Fax:763-441-0591
Is Sole Proprietor?:No
Enumeration Date:2022-02-27
Last Update Date:2023-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN14584363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant