Tilstra, David J
Tilstra, David J is an individual health care provider with primary practice located at 1900 Centracare Cir , Saint Cloud MN 56303-5000. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.), Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) is his primary health care specialty. Tilstra, David J can be contacted via phone (320) 654-3630.Contact Information
Primary practice address
1900 Centracare Cir
Saint Cloud MN 56303-5000
Phone: (320) 654-3630
Fax: (320) 654-3657
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Clinical Genetics (M.D.) | 207SG0201X | 37920 | Minnesota |
Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 37920 | Minnesota |
Profile Details
NPI number | 1316928351 |
---|---|
LBN Legal business name | Tilstra, David J |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Nov 8th, 2005 |
Last updated | Dec 13th, 2011 - about 14 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1316928351 | NPPES |
Other | 1008055 | PREFERRED ONE | |
Other | 763003 | PREFERRED ONE | |
Other | 51A44TI | PREFERRED ONE | |
Other | 1200086 | PREFERRED ONE | |
Other | 2089340 | PREFERRED ONE | |
Other | 7713350 | PREFERRED ONE | |
Other | HP25528 | PREFERRED ONE | |
Other | 074814500 | PREFERRED ONE | |
Other | 110417 | PREFERRED ONE |
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