Dahle, Thom G. A.

Dahle, Thom G. A. is an individual health care provider with primary practice located at 1200 6Th Ave N Centracare Clinic, Saint Cloud MN 56303-2735. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Dahle, Thom G. A. can be contacted via phone (320) 252-5131.

Contact Information

Primary practice address
1200 6Th Ave N Centracare Clinic Saint Cloud MN 56303-2735
Phone: (320) 252-5131
Fax: (952) 883-5395
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 46342 Minnesota
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X 46342 Minnesota

Profile Details

NPI number 1760458673
LBN Legal business name Dahle, Thom G. A.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 28th, 2006
Last updated Dec 5th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760458673 NPPES
Minnesota MEDICAID 869632200

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