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NPI Code Detail

MEDICARE: TERRILL ROSBOROUGH MD

MEDICARE: TERRILL ROSBOROUGH 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
1207R00000XInternal Medicine Physician21926MN

General Provider Information

NPI Number : 1669431177
Entity Type Code : Individual
Provider Name (Legal Business Name) : TERRILL ROSBOROUGH MD
Provider Business Mailing Address
First Line : PO BOX 43
Second Line : MR 10809
City : MINNEAPOLIS
State : MN
Zip : 55440-0043
Country : US
Telephone Number : 612-262-4813
Fax Number : 612-262-4194
Provider Business Practice Location Address
First Line : 2800 CHICAGO AVE
Second Line : 250
City : MINNEAPOLIS
State : MN
Zip : 55407-1318
Country : US
Telephone Number : 612-863-4212
Fax Number : 612-863-2132
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2006
Last Update Date : 07/08/2007

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Directions to “ TERRILL ROSBOROUGH MD” Practice Location

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