DR. Glenn Leroy Detlefsen, M.D.

NPI #1013052554 in Rosemount, Minnesota

Provider Information

NPI Number: 1013052554
Entity Type: Individual
Name: DR. Glenn Leroy Detlefsen, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Family Medicine
Credential: M.D.
Enumeration Date: Feb 21, 2007
Last Updated: Jul 8, 2007

Practice Location

Address: 15120 CHIPPENDALE AVE W
City: Rosemount
State: Minnesota
ZIP Code: 55068-1796
Phone: (651) 423-4114

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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