Provider Demographics
NPI:1386752863
Name:GERMANSON, TWILA B (MD)
Entity type:Individual
Prefix:
First Name:TWILA
Middle Name:B
Last Name:GERMANSON
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1161 WAYZATA BLVD E # 228
Mailing Address - Street 2:
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-1935
Mailing Address - Country:US
Mailing Address - Phone:952-956-4057
Mailing Address - Fax:952-333-8196
Practice Address - Street 1:13911 RIDGEDALE DR., STE 320
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305
Practice Address - Country:US
Practice Address - Phone:952-956-4057
Practice Address - Fax:952-333-8196
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-26
Last Update Date:2020-12-15
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Provider Licenses
StateLicense IDTaxonomies
MN432942084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN279G1GEOtherBCBS MN
MN816898900Medicaid
MN171122OtherVCARE