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1407818016
EDSON VERCEL FUGLESTAD
FRIDLEY, MN
NPI
1407818016
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: MN 15811)
Enumeration Date
2006-04-06
Last Update Date
2007-07-08
Business Address
Dr. EDSON VERCEL FUGLESTAD M.D.
6341 UNIVERSITY AVE NE
FRIDLEY, MN 55432-4946
Phone number: 763-572-5710
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Mailing Address
Dr. EDSON VERCEL FUGLESTAD M.D.
6401 UNIVERSITY AVE NE
FRIDLEY, MN 55432-4341
Phone number: 763-572-5710
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