Larson, Matthew James

Larson, Matthew James is an individual health care provider with primary practice located at 1215 Town Centre Dr Suite 200, Eagan MN 55123-1033. He recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as his primary health care specialty. Larson, Matthew James can be contacted via phone (651) 251-3300.

Contact Information

Primary practice address
1215 Town Centre Dr Suite 200 Eagan MN 55123-1033
Phone: (651) 251-3300
Fax: (651) 255-3450
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 46578 Minnesota

Profile Details

NPI number 1154386423
LBN Legal business name Larson, Matthew James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 19th, 2006
Last updated Oct 2nd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154386423 NPPES
Minnesota Other 070001049 MEDICARE PTAN
Minnesota Other 0FE27LA MEDICARE PTAN
Minnesota Other 0030001093 MEDICARE PTAN
Minnesota Other P01199766 MEDICARE PTAN

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