Individual
DANIEL W REYNOLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11850 BLACKFOOT ST NW STE 130, COON RAPIDS, MN 55433-2583
(763) 236-9000
(763) 236-9010
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
36923
MN
208600000X
Surgery Physician
53998
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246225700
—
MN
05
—
34090600
—
WI
Enumeration date
02/22/2006
Last updated
04/21/2021
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