Basic Information
| Provider Information | |||||||||
| NPI: | 1477658771 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LAPRADE | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | F | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4200 DAHLBERG DR STE 300 | ||||||||
| Address2: | |||||||||
| City: | GOLDEN VALLEY | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554224841 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7635207870 | ||||||||
| FaxNumber: | 7635207580 | ||||||||
| Practice Location | |||||||||
| Address1: | 4010 W 65TH ST | ||||||||
| Address2: | |||||||||
| City: | EDINA | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554351706 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9524567000 | ||||||||
| FaxNumber: | 9524567001 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2006 | ||||||||
| LastUpdateDate: | 05/21/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 39368 | MN | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 32244500 | 05 | WI | MEDICAID | 7777470 | 05 | SD | MEDICAID | 09-13819 | 01 | MN | MEDICA-CHOICE | OTHER | 34Y50LA | 01 | MN | BLUE CROSS BLUE SHIELD | OTHER | 881227600 | 05 | MN | MEDICAID | 10387 | 05 | ND | MEDICAID | 1933929 | 05 | IA | MEDICAID | 1012097 | 01 | MN | PREFERRED ONE | OTHER | 0971871 | 01 | MN | MEDICA-PRIMARY | OTHER | 114957 | 01 | MN | U CARE | OTHER | HP22029 | 01 | MN | HEALTH PARTNERS | OTHER | 095141 | 01 | MN | FAIRVIEW | OTHER | 768220 | 01 | ARAZ | OTHER |