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Individual

RICHARD D SUDMEIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
508 10TH ST, WORTHINGTON, MN 56187-2343
(507) 372-2921
(507) 372-1815
Mailing address
508 10TH ST, WORTHINGTON, MN 56187-2343
(507) 372-2921
(507) 372-1815

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
22262
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00738SU
BCBS MPIN
MN
01
109796
UCARE
FM
01
110164496
RR MEDICARE
MN
05
1958918
IA
05
343388900
MN
Enumeration date
09/14/2006
Last updated
03/29/2011
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