Dr Andrew W Larson, MD | |
13980 Northdale Blvd, Rogers, MN 55374-2147 | |
(763) 428-1920 | |
(763) 428-3162 |
Full Name | Dr Andrew W Larson |
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Gender | Male |
Speciality | Pediatrics |
Location | 13980 Northdale Blvd, Rogers, Minnesota |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1700853397 | NPI | - | NPPES |
165517500 | Medicaid | MN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 41197 (Minnesota) | Primary |
Entity Name | Children's Clinic Network |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1447529235 PECOS PAC ID: 5890949192 Enrollment ID: O20130214000538 |
Mailing Address | Practice Location Address |
---|---|
Dr Andrew W Larson, MD 13980 Northdale Blvd, Rogers, MN 55374-2147 Ph: (763) 428-1920 | Dr Andrew W Larson, MD 13980 Northdale Blvd, Rogers, MN 55374-2147 Ph: (763) 428-1920 |
Dr. Daniel A Albright, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 13688 Rogers Dr Ste 230, Rogers, MN 55374 Phone: 952-977-0300 Fax: 952-977-0311 | |
Dr. Naomi C. Palmer, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 13980 Northdale Blvd, Rogers, MN 55374 Phone: 763-428-1920 Fax: 763-428-3162 | |
Dr. Wade M. Larson, M.D. Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 13980 Northdale Blvd, Rogers, MN 55374 Phone: 763-428-1920 Fax: 763-428-3162 | |
Dr. Mary E. Mahony, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 13980 Northdale Blvd, Rogers, MN 55374 Phone: 763-428-1920 Fax: 763-428-3162 |