Samuelson, Thomas W

Samuelson, Thomas W is an individual health care provider with primary practice located at 10709 Wayzata Blvd Ste 200 , Minnetonka MN 55305-5509. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Samuelson, Thomas W can be contacted via phone (952) 888-5800.

Contact Information

Primary practice address
10709 Wayzata Blvd Ste 200 Minnetonka MN 55305-5509
Phone: (952) 888-5800
Fax: (952) 567-6156
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 30302 Minnesota

Profile Details

NPI number 1265427918
LBN Legal business name Samuelson, Thomas W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 19th, 2005
Last updated Aug 4th, 2023 - about 3 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 1265427918 NPPES
Minnesota MEDICAID 851008300
Minnesota MEDICAID 31696600

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