Male or Other

Michael R. Timm PAC

Physician Assistant in St Paul, MN(View on Map)

Full Name

Michael R Timm PAC

NPI Number

1245202399

NPI Type

Individual Provider

Gender

Male

Enumeration Date

02/03/2006

Specialties

(Taxonomies)

Code

363A00000X

Primary Taxonomy

Yes

Licenses

State

Minnesota

License Number

9878

Contact
Information

Purpose

Mailing
Location

Address

8100 34TH AVE S
640 JACKSON ST

City

Bloomington
St Paul

State

MN
MN

Postal Code

55425-1672
55101-2502

Country

US
US

Telephone Number

(952) 883-5463
(651) 254-5701

Identifiers

Identifier

660159600

Identifier State

MN

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 03/13/2015

Provider Address

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