Individual
DR. ANDREW W. LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13980 NORTHDALE BLVD, ROGERS, MN 55374-2147
(763) 428-1920
(763) 428-3162
Mailing address
13980 NORTHDALE BLVD, ROGERS, MN 55374-2147
(763) 428-1920
(763) 428-3162
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
41197
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
165517500
—
MN
Enumeration date
03/02/2006
Last updated
09/22/2011
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