Individual
JOHN R LIDDICOAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7601 NORTHLAND DR N, MINNEAPOLIS, MN 55428-4500
(763) 360-7961
Mailing address
2208 OLIVER AVE S, MINNEAPOLIS, MN 55405-2441
(763) 360-7961
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
209670
MA
Other
Enumeration date
10/04/2007
Last updated
10/04/2007
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