Individual
SHANNON TOMFOHRDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
927 CHURCHILL ST W, STILLWATER, MN 55082-6605
(651) 430-4529
Mailing address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
23147
WI
207P00000X
Emergency Medicine Physician
Primary
65442
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/10/2016
Last updated
01/31/2024
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