Individual
DR. JOSHUA WILLIAM MARVIN THEISEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD-PHD
Contact information
Practice address
2450 RIVERSIDE AVENUE, MINNEAPOLIS, MN 55454-1002
(612) 365-1000
Mailing address
2450 RIVERSIDE AVENUE, MINNEAPOLIS, MN 55454-1450
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
2012020973
MO
Other
Enumeration date
07/08/2012
Last updated
12/06/2018
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