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:
Health care specialties
| Specialty | Code | License # | 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 12 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| 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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