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Individual

CHAD A HAROLDSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1200 SIXTH AVE NO, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(320) 252-5131
Mailing address
1200 SIXTH AVE NO, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
101566
MN
207RN0300X
Nephrology Physician
Primary
47418
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
968137000
MN
Enumeration date
03/24/2006
Last updated
08/18/2008
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