Individual
ROLAND ROY LARTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1010 S BIRCH AVE, HALLOCK, MN 56728-4215
(218) 843-2868
Mailing address
1010 S BIRCH AVE, P.O. BOX 700, HALLOCK, MN 56728-4215
(218) 843-2868
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17741
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
17741
MD LICENSE
MN
Enumeration date
06/28/2006
Last updated
07/08/2007
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