Provider Demographics
NPI:1215913280
Name:TESTERMAN, PATRICK ALLEN (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:ALLEN
Last Name:TESTERMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:ANESTHESIA P4
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:612-873-3458
Mailing Address - Fax:612-904-4218
Practice Address - Street 1:701 PARK AVE
Practice Address - Street 2:ANESTHESIA P4
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-3458
Practice Address - Fax:612-904-4218
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2011-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN46425207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN053403000Medicaid
MN053403000Medicaid
MNI32652Medicare UPIN