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Organization

DAVID C. ANDERHOLM, MD, PA

Active
Other names
Northern Psychiatric Associates
Organization subpart
No

Provider details

NPI number
Authorized official
ELLIOT RICHELSON M.D. (DIRECTOR, PRESIDENT, SECRETARY, AND)
(904) 605-4986
Entity
Organization

Contact information

Practice address
7115 FORTHUN RD, SUITE 105, BAXTER, MN 56425-8597
(218) 454-0090
(218) 454-0091
Mailing address
7115 FORTHUN RD, SUITE 105, BAXTER, MN 56425-8597
(218) 454-0090
(218) 454-0091

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
503580500
MN
01
55A48AN
BCBS
MN
Enumeration date
08/31/2006
Last updated
03/15/2023
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