Search › Minnesota › 207Q00000X
Shane Richardson, M.D
NPI 1659710374 · on the registry since 2013
Practice
- Address
- 927 Trettel Ln
Cloquet, MN 55720 - Phone
- (218) 879-1227
- Organisation at this address
- Fdl Adolescent Outpatient Tx
Fond Du Lac Reservation Business Committee
Fond Du Lac Reservation Business CommitteeInferred from a shared address, not stated in the registry. - Clinicians at this address
- 74
Additional practice sites
- 707 N Alvernon Way, Tucson, AZ
- 221 W 4th St, Duluth, MN
Registry record
- Primary taxonomy
- 207Q00000X
207Q00000X
- Also registered as
- 207Q00000X
- Licence states on file
- AZ, MN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2019-01-29
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota