Provider Demographics
NPI:1669478723
Name:VARECKA, THOMAS F (MD)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:F
Last Name:VARECKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2805 CAMPUS DR
Mailing Address - Street 2:STE 425
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-2680
Mailing Address - Country:US
Mailing Address - Phone:763-383-0770
Mailing Address - Fax:763-383-0777
Practice Address - Street 1:2805 CAMPUS DR
Practice Address - Street 2:STE 425
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-2680
Practice Address - Country:US
Practice Address - Phone:763-383-0770
Practice Address - Fax:763-383-0777
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN22452207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN200000763Medicare ID - Type Unspecified
MNA94890Medicare UPIN