Provider Demographics
NPI:1649495037
Name:TROEDSON, ARTHUR PETER (MD)
Entity type:Individual
Prefix:
First Name:ARTHUR
Middle Name:PETER
Last Name:TROEDSON
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2336 LEXINGTON AVE N
Mailing Address - Street 2:CORRECTIONAL MEDICAL SERVICES INC
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113
Mailing Address - Country:US
Mailing Address - Phone:651-631-0065
Mailing Address - Fax:651-631-0096
Practice Address - Street 1:1101 LINDEN LN
Practice Address - Street 2:MINNESOTA CORRECTIONAL FACILITY FARIBAULT HEALTH SVCS
Practice Address - City:FARIBAULT
Practice Address - State:MN
Practice Address - Zip Code:55021-6400
Practice Address - Country:US
Practice Address - Phone:507-334-0774
Practice Address - Fax:507-334-0730
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-16
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Provider Licenses
StateLicense IDTaxonomies
MN31023207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
A93848Medicare UPIN