# RANDALL S. VOLLERTSEN MD. INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MDCare
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396818613
- **Authorized official:** KELLY MUCHOW (MANAGER)
- **Authorized official phone:** (952) 974-3200

## Contact information

- **Practice address:** 4729 COUNTY ROAD 101, MINNETONKA, MN 55345-2634
- **Practice address phone:** (952) 974-3200
- **Practice address fax:** (952) 974-3201
- **Mailing address:** 4729 COUNTY ROAD 101, MINNETONKA, MN 55345-2634
- **Mailing address phone:** (952) 974-3200
- **Mailing address fax:** (952) 974-3201

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207RR0500X | Rheumatology Physician | 22501 | MN | Yes |

## Other

- **Enumeration date:** 11/16/2006
- **Last updated:** 08/22/2020