PETER PAUL FODERICK (NPI# 1336315043) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336315043 |
| Entity Type | Individual |
| Full Name | PETER PAUL FODERICK |
| Credential | M.D. |
| Practice Address |
506 4th Ave W 506 Fourth Ave.w Ada MN 56510-1011 |
| Mailing Address |
506 Fourth Ave.w P.o.box189 Ada MN 56510-0189 |
| Practice Telephone | 2187844848 |
| Mailing Telephone | 2187844848 |
| Enumeration Date | 2008-05-02 |
| Last Update Date | 2008-05-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 13953 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
506 4TH AVE W 506 FOURTH AVE.W |
| City | ADA |
| State | MN |
| Zip Code | 56510-1011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508917659 | Angela Marie Skyberg | Physician Assistant | Bridges Medical Center, 201 9th Street W., Ada, MN 56510 | 2007-01-16 |
| 1104915990 | David Carl Solseng | Optometrist | 402 E 3rd St, Suite #1, Ada, MN 56510 | 2006-10-12 |
| 1982612099 | Sandra Lee Martsching | Family Medicine | 201 9th Street West, Bridges Medical Center, Ada, MN 56510 | 2006-08-04 |
| 1326579335 | Bridges Medical Center | Ambulance | 201 9th St W, Ada, MN 56510 | 2017-03-22 |
| 1598908543 | Amy C. Haen-sawrey | Speech-Language Pathologist | Bridges Medical Center, 201 9th Street West, Ada, MN 56510 | 2009-04-07 |
| 1669523718 | Renae L Miller | Physician Assistant | Bridges Medical Center, 201 9th Street W., Ada, MN 56510 | 2007-01-16 |
| 1447310636 | Prairie Dental Centers Pa | Dentist | 200 E Main St, Ada, MN 56510 | 2006-12-11 |
| 1043309651 | Thrifty Drug Stores Inc | Pharmacy | 319 W Main St, Ada, MN 56510 | 2006-10-12 |
| 1336241785 | Kennedy Henry Thomas | Chiropractor | 406 E Main St, Ada, MN 56510 | 2006-09-05 |
| 1710074109 | Independent School District #2854 | Local Education Agency (LEA) | 604 W Thorpe Ave, Ada, MN 56510-1027 | 2006-10-06 |
| Find all providers in zip 56510 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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|---|---|---|---|---|
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| 1295024891 | Shaun Erin O'toole | General Practice | 1771 Highgrove Dr Se, Ada, MI 49301-9287 | 2011-04-04 |
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| 1447654678 | Chs Tennessee Medical, P.C. | General Practice | 610 Opperman Dr, Thomson Reuters Campus, Eagan, MN 55123-1340 | 2014-10-17 |
| 1922422989 | Roger J. Day | General Practice | 9701 Xebec St Ne, Circle Pines, MN 55014-2508 | 2014-02-12 |
| 1760724827 | Ahmednur Abdirahman | General Practice | 10750 Brunswick Rd Apt 111, Bloomington, MN 55438-1860 | 2013-03-26 |
| 1225385891 | Felix Cristobal Blanco | General Practice | 10 Fourth Ave Se, Glenwood, MN 56334-1820 | 2012-08-13 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.