Individual
DR. MITCHELL HARRIS CRIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2800 CAMPUS DR STE 10, PLYMOUTH, MN 55441-8812
(763) 559-2171
Mailing address
2800 CAMPUS DR STE 10, PLYMOUTH, MN 55441-8812
(763) 559-2171
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
49502
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00864018
RAILROAD MEDICARE
MN
Enumeration date
02/17/2007
Last updated
02/28/2023
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