Individual
TERRY BOKSBERGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
250 CENTRAL AVE N, SUITE 228, WAYZATA, MN 55391-1206
(952) 993-8250
(952) 993-8276
Mailing address
8170 33RD AVE S, PO BOX 1309 MAIL STOP 21110Q, MINNEAPOLIS, MN 55425-4516
(952) 993-8250
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
107105
MN
207Q00000X
Family Medicine Physician
2011-00868
NC
207Q00000X
Family Medicine Physician
5101016814
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5919235
—
NC
Enumeration date
08/18/2007
Last updated
02/25/2016
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