Individual
MATTHEW MOLDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14700 28TH AVE N STE 20, PLYMOUTH, MN 55447
(763) 559-3779
(763) 450-3986
Mailing address
PO BOX 47159, PLYMOUTH, MN 55447-0159
(763) 559-3779
(763) 450-3986
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
59500
MN
207P00000X
Emergency Medicine Physician
59500
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/01/2014
Last updated
07/31/2018
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