Provider Demographics
NPI: | 1760589568 |
---|---|
Name: | MILBRANDT, TODD ALAN (MD) |
Entity type: | Individual |
Prefix: | |
First Name: | TODD |
Middle Name: | ALAN |
Last Name: | MILBRANDT |
Suffix: | |
Gender: | M |
Credentials: | MD |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 200 1ST ST SW |
Mailing Address - Street 2: | |
Mailing Address - City: | ROCHESTER |
Mailing Address - State: | MN |
Mailing Address - Zip Code: | 55905-0001 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 507-284-2511 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 200 1ST ST SW |
Practice Address - Street 2: | |
Practice Address - City: | ROCHESTER |
Practice Address - State: | MN |
Practice Address - Zip Code: | 55905-0001 |
Practice Address - Country: | US |
Practice Address - Phone: | 507-284-2511 |
Practice Address - Fax: | |
Is Sole Proprietor?: | No |
Enumeration Date: | 2006-09-20 |
Last Update Date: | 2025-01-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WI | 84549 | 207X00000X |
MN | 107710 | 207X00000X |
KY | 39538 | 207XX0801X |
MN | 58633 | 207X00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization |
---|---|---|---|---|
Yes | 207X00000X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | |
No | 207XX0801X | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Orthopaedic Trauma |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
KY | 64098775 | Medicaid | |
MN | H400155065 | Medicare PIN | |
KY | 64098775 | Medicaid |