Individual
BRUCE WILES RICHARDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1185 TOWN CENTRE DR STE 220, EAGAN, MN 55123-1186
(651) 379-1600
(651) 379-1650
Mailing address
1185 TOWN CENTRE DR STE 220, EAGAN, MN 55123-1186
(651) 379-1600
(651) 379-1650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25475
MN
2083B0002X
Obesity Medicine (Preventive Medicine) Physician
25475
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
72226700
—
MN
Enumeration date
03/28/2006
Last updated
04/05/2026
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