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Individual

DR. LARRY DEAN WADELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
631 1ST ST SE, FARIBAULT, MN 55021-6362
(507) 334-8333
Mailing address
7676 MARINER DR, MAPLE GROVE, MN 55311-2615
(763) 494-9397
(763) 494-5518

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33713
MN

Other

Enumeration date
09/16/2006
Last updated
07/08/2007
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