MEDICARE: ARTHUR PETER TROEDSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	31023	MN

General Provider Information

NPI Number	:	1649495037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ARTHUR PETER TROEDSON MD

Provider Business Mailing Address
First Line	:	2336 LEXINGTON AVE N
Second Line	:	CORRECTIONAL MEDICAL SERVICES INC
City	:	ROSEVILLE
State	:	MN
Zip	:	55113
Country	:	US
Telephone Number	:	651-631-0065
Fax Number	:	651-631-0096

Provider Business Practice Location Address
First Line	:	1101 LINDEN LN
Second Line	:	MINNESOTA CORRECTIONAL FACILITY FARIBAULT HEALTH SVCS
City	:	FARIBAULT
State	:	MN
Zip	:	55021-6400
Country	:	US
Telephone Number	:	507-334-0774
Fax Number	:	507-334-0730

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/13/2007
Last Update Date	:	07/16/2007

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