Organization
INFECTIOUS DISEASE CONSULTANTS PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL JOEL ANDERSON M.D. (PRESIDENT)
(952) 746-8360
Entity
Organization
Contact information
Practice address
11676 WAYZATA BLVD, MINNETONKA, MN 55305-2009
(952) 746-8360
(952) 746-8368
Mailing address
11676 WAYZATA BLVD, MINNETONKA, MN 55305-2009
(952) 746-8360
(952) 746-8368
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
1201
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
533313000
—
MN
01
—
CO0011
RAILROAD MEDICARE
MN
Enumeration date
03/13/2007
Last updated
12/02/2016
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