Individual
THOMAS W SAMUELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10709 WAYZATA BLVD STE 200, MINNETONKA, MN 55305-5509
(952) 888-5800
(952) 567-6156
Mailing address
9801 DUPONT AVE S, SUITE 425, BLOOMINGTON, MN 55431-3100
(652) 567-6092
(952) 567-6176
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
30302
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31696600
—
WI
05
—
851008300
—
MN
Enumeration date
09/19/2005
Last updated
08/04/2023
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