Provider Demographics
NPI:1588721575
Name:THOMASSON, ROBERT D (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:D
Last Name:THOMASSON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:5482 MEISTER RD
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-6026
Mailing Address - Country:US
Mailing Address - Phone:952-975-0863
Mailing Address - Fax:952-937-0999
Practice Address - Street 1:6401 FRANCE AVE S
Practice Address - Street 2:SKYWAY LOBBY
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-2104
Practice Address - Country:US
Practice Address - Phone:952-924-5030
Practice Address - Fax:952-937-0999
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN17406207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNA96556Medicare UPIN