Individual
MR. ANDREW JON LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
9900 13TH AVENUE NORTH, SUITE 2A, PLYMOUTH, MN 55441-5035
(763) 525-0363
(763) 525-0369
Mailing address
9900 13TH AVENUE NORTH, SUITE 2A, PLYMOUTH, MN 55441-5035
(763) 525-0363
(763) 525-0369
Taxonomy
Speciality
Code
Description
License number
State
207ZD0900X
Dermatopathology (Pathology) Physician
Primary
02003283A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02003283A
INDIANA PROFESSIONAL LICENSING AGENCY
IN
Enumeration date
06/23/2009
Last updated
10/17/2014
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