Individual
MR. TED L. TRUEBLOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
221 MAIN ST N, PIERZ, MN 56364-1570
(320) 468-2587
(320) 468-6219
Mailing address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41752
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080010201
MEDICARE WPS - AITKIN CLI
MN
01
—
080010202
MEDICARE WPS - HOSPITAL
MN
01
—
080010210
MEDICARE WPS - MCGREGOR C
MN
01
—
080015849
MEDICARE WPS - GARRISON C
MN
05
—
920719800
—
MN
Enumeration date
03/08/2006
Last updated
01/15/2016
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