Individual
A. DOUGLAS LANDERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
(218) 847-0881
Mailing address
1027 WASHINGTON AVE, DETROIT LAKES, MN 56501-3409
(218) 847-5611
(218) 847-0881
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0281722
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10028
MNBS #
MN
01
—
142029
UCARE #
MN
01
—
14275
SIOUX VALLEY #
MN
01
—
14566LA
MNBS #
MN
05
—
14862
—
MN
01
—
1602750
MEDICA #
MN
01
—
2012
NDBS #
ND
01
—
2608
NDBS #
MN
05
—
283877000
—
MN
01
—
28957LA
MNBS #
MN
01
—
904873
AMERICA'S PPO/ARAZ #
MN
01
—
92181LA
MNBS #
ND
01
—
HP25796
HEALTHPARTNERS #
MN
01
—
ND200040
LHS/BANNERHEALTH #
ND
Enumeration date
05/31/2006
Last updated
05/07/2012
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