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Individual

DR. THEODORE SURDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHD LP

Contact information

Practice address
1227 CALEDONIA ST, MANKATO, MN 56001-4329
(507) 388-8874
(507) 685-4807
Mailing address
1227 CALEDONIA ST, MANKATO, MN 56001-4329
(507) 388-8874
(507) 685-4807

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
LP3385
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
06T04SU
BXBS
MN
01
114945
UNITED
FM
01
114945
UCARE MINNESOTA
MN
05
497823400
MN
01
HP28628
HEALTH PARTNERS
MN
Enumeration date
05/12/2006
Last updated
03/16/2023
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