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General NPI Number Information
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NPI Number | 1699653956
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Entity Type | Organization
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Legal Business Name | MAGNUS VETERANS FOUNDATION
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Dates
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Enumeration Date | 08/25/2025
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 16861 N DIAMOND LAKE RD
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City | DAYTON
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State | MN
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Zip | 55327-9590
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Country | US
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Telephone | 763-427-7832
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Fax |
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Provider Business Mailing Address
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Address Line | 16861 N DIAMOND LAKE RD
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City | DAYTON
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State | MN
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Zip | 55327-9590
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Country | US
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Telephone | 763-427-7832
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. SHAWN ALDERMAN
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Credential | MD
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Telephone | 360-704-0421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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