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TODD M OFFICER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
705 PLEASANT AVE S, PARK RAPIDS, MN 56470-1440
(218) 732-2800
(218) 732-2874
Mailing address
PO BOX 1450 # NW7813, MINNEAPOLIS, MN 55485-0001
(218) 732-2800
(218) 732-2874

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
52316
MN
207Q00000X
Family Medicine Physician
RL-0437
SD
207Q00000X
Family Medicine Physician
TP-104372
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
492921
WELLMARK
SD
01
4992652
WELLMARK
SD
01
4994117
WELLMARK
SD
05
5612800
SD
05
5612802
SD
05
5612803
SD
01
7038
DAKOTACARE
SD
01
P00463249
RR MEDICARE
SD
Enumeration date
05/24/2006
Last updated
10/18/2011
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