Individual
RICHARD G WICKLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2220 RIVERSIDE AVE, HEALTHPARTNERS RIVERSIDE URGENT CARE CLINIC, MINNEAPOLIS, MN 55454-1321
(952) 853-8800
(612) 371-1732
Mailing address
8170 33RD AVE S, MS21110Q, MINNEAPOLIS, MN 55425-4516
(952) 883-5375
(612) 371-1732
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
17804
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
662082500
—
MN
Enumeration date
02/22/2006
Last updated
12/23/2011
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