Individual
DR. MATS LARS LIDEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
166 19TH STREET SOUTH, SUITE 100, SARTELL, MN 56377-2154
(320) 251-0609
Mailing address
PO BOX 1450 NW 6035, MINNEAPOLIS, MN 55485-6035
(952) 542-8553
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
55109
MN
2085R0202X
Diagnostic Radiology Physician
5748
NE
Other
Enumeration date
07/09/2008
Last updated
09/13/2012
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