MEDICARE: RANDALL ORA CARD 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	4301058040	MI
2	207Q00000X	Family Medicine Physician	37087	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356332407
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RANDALL ORA CARD MD

Provider Business Mailing Address
First Line	:	320 E MAIN ST
Second Line	:
City	:	CROSBY
State	:	MN
Zip	:	56441-1645
Country	:	US
Telephone Number	:	218-546-7000
Fax Number	:	218-545-4456

Provider Business Practice Location Address
First Line	:	320 E MAIN ST
Second Line	:
City	:	CROSBY
State	:	MN
Zip	:	56441-1645
Country	:	US
Telephone Number	:	218-546-7000
Fax Number	:	218-545-4456

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

Provider Enumeration Date	:	10/28/2005
Last Update Date	:	12/12/2012

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Directions to “ RANDALL ORA CARD MD” Practice Location

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