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Individual

DAVID STEVEN HOMORODY

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M ED LP

Contact information

Practice address
540 E 1ST ST, WACONIA, MN 55387-1601
(952) 442-4437
(952) 442-3084
Mailing address
540 E 1ST ST, WACONIA, MN 55387-1601
(952) 442-4437
(952) 442-3084

Taxonomy

Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP1243
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
07F63H0
BCBS
MN
01
1013392
PREFERRED ONE
MN
01
116478
U CARE
MN
01
6260133
UBH MEDICA
MN
01
HP32686
HEALTH PARTNERS
MN
Enumeration date
08/15/2005
Last updated
07/08/2007
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