Individual
FREDERICK E DEMEUSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
7595 ANAGRAM DR, EDEN PRAIRIE, MN 55344-7399
(612) 573-2200
(612) 573-2274
Mailing address
7595 ANAGRAM DR, EDEN PRAIRIE, MN 55344-7399
(612) 573-2200
(612) 573-2274
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9865
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
527430300
—
MN
Enumeration date
05/16/2006
Last updated
08/01/2023
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