Komoto, Timothy S

Komoto, Timothy S is an individual health care provider with primary practice located at 200 Bunker Hill Dr , Aitkin MN 56431-1865. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Komoto, Timothy S can be contacted via phone (218) 927-2157.

Contact Information

Primary practice address
200 Bunker Hill Dr Aitkin MN 56431-1865
Phone: (218) 927-2157
Fax: (218) 927-4130
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 26655 Minnesota

Profile Details

NPI number 1972678753
LBN Legal business name Komoto, Timothy S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 21st, 2006
Last updated Nov 5th, 2020 - about 5 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 1972678753 NPPES
Minnesota MEDICAID 411008100
Minnesota Other 080015564
Minnesota Other 080015565
Minnesota Other 080015846
Minnesota Other 080015566

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