Whalio Doctors

NPI 1205956489

Gordon Ditmanson, MD

Practitioner Specialist Saint Paul, MN

Practice location

Address
347 Smith Ave N Suite 203, Saint Paul, MN 55102-2387
Phone
(651) 241-7733
Mailing address
2148 Iglehart Ave, Saint Paul, MN 55104-5049

Registered specialties

Specialist Primary
Other Service Providers Taxonomy 174400000X Licence 24273 (MN)

Registry record

NPI
1205956489
Entity type
Individual
Sex (as registered)
Male
NPI issued
30 Mar 2007
Record last updated
8 Jul 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.