Individual
RICHARD WAHLSTROM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2500 SHERIDAN AVE S, MINNEAPOLIS, MN 55405-2342
(612) 377-7863
(612) 374-1355
Mailing address
2500 SHERIDAN AVE S, MINNEAPOLIS, MN 55405-2342
(612) 377-7863
(612) 374-1355
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21093
MN
Other
Enumeration date
12/22/2005
Last updated
08/20/2009
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