Provider Demographics
NPI:1689600595
Name:TRUSHEIM, JOHN EDWIN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:EDWIN
Last Name:TRUSHEIM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3400 W 66TH ST
Mailing Address - Street 2:SUITE 150
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-2109
Mailing Address - Country:US
Mailing Address - Phone:952-920-7200
Mailing Address - Fax:763-302-4234
Practice Address - Street 1:3400 W 66TH ST
Practice Address - Street 2:SUITE 150
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2109
Practice Address - Country:US
Practice Address - Phone:952-920-7200
Practice Address - Fax:763-302-4234
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN305352084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN100308C029OtherUCARE
MN0512971OtherMEDICA
WI30801600Medicaid
MNHP14579OtherHEALTHPARTNERS
MN130004262OtherRAILROAD MEDICARE
MN0265025OtherPREFERRED ONE
MN17983TROtherBCBS OF MN
MN091283200Medicaid
MN22685OtherAMERICA'S PPO
MN22685OtherAMERICA'S PPO
MN091283200Medicaid