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General NPI Number Information
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NPI Number | 1114972221
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Entity Type | Individual
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Provider Name | TODD M OFFICER MD
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Gender | Male
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 10/18/2011
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Provider Practice Location Address
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Address Line | 705 PLEASANT AVE S
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City | PARK RAPIDS
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State | MN
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Zip | 56470-1440
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Country | US
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Telephone | 218-732-2800
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Fax | 218-732-2874
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Provider Business Mailing Address
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Address Line | PO BOX 1450 # NW7813
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City | MINNEAPOLIS
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State | MN
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Zip | 55485-0001
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Country | US
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Telephone | 218-732-2800
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Fax | 218-732-2874
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | RL-0437
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 52316
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | TP-104372
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License Number State | MN
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