Individual
DR. RUSSELL G SMIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1885 PLAZA DR, PARK NICOLLET CLINIC - EAGAN, EAGAN, MN 55122-2612
(952) 993-4001
(952) 993-4075
Mailing address
6465 WAYZATA BLVD, STE 315, ST LOUIS PARK, MN 55426-1728
(952) 993-7169
(952) 993-0300
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
38657
MN
Other
Enumeration date
12/27/2005
Last updated
10/06/2011
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