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General NPI Number Information
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NPI Number | 1932636685
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Entity Type | Individual
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Provider Name | ERIC DAVID VALDER D.O.
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Gender | Male
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Dates
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Enumeration Date | 05/12/2017
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Last Update Date | 10/28/2024
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Provider Practice Location Address
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Address Line | 501 STATE ST N
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City | WASECA
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State | MN
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Zip | 56093-2811
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Country | US
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Telephone | 507-835-1210
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Fax |
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Provider Business Mailing Address
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Address Line | 200 1ST ST SW
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City | ROCHESTER
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State | MN
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Zip | 55905-0001
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Country | US
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Telephone | 507-284-2511
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Fax |
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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 | 73674
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 64600
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License Number State | MN
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