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Individual

DR. MICHAEL EDWARD NEUDECKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
811 2ND ST SE, SUITE A, LITTLE FALLS, MN 56345-3559
(320) 631-7000
(320) 632-0534
Mailing address
811 2ND ST SE, SUITE A, LITTLE FALLS, MN 56345-3559
(320) 631-7000
(320) 632-0534

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26011
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0103874
MEDICA
01
112332C736
UCARE MINNEOSTA
MN
01
21629
AMERICA'S PPO
01
54682NE
BCBS OF MINNESOTA
MN
05
757703600
MN
01
A011
TRICARE
MN
01
HP11117
HEALTH PARTNERS
01
NA9230454511
PREFERRED ONE
Enumeration date
07/07/2006
Last updated
11/07/2012
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