Van Tyn, Marlieke
Van Tyn, Marlieke is an individual health care provider with primary practice located at 233 Grand Ave Pediatric And Young Adult Medicine, Pa, Saint Paul MN 55102-2331. She recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is her primary health care specialty. Van Tyn, Marlieke can be contacted via phone (651) 227-7806.Contact Information
Primary practice address
233 Grand Ave Pediatric And Young Adult Medicine, Pa
Saint Paul MN 55102-2331
Phone: (651) 227-7806
Fax: (651) 256-6710
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 42369 | Minnesota |
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 207PP0204X | 42369 | Minnesota |
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 42369 | Minnesota |
| Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine | 2080P0204X | 42369 | Minnesota |
Profile Details
| NPI number | 1487731527 |
|---|---|
| LBN Legal business name | Van Tyn, Marlieke |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 1st, 2006 |
| Last updated | May 6th, 2008 - about 16 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 | 1487731527 | NPPES |
| Minnesota | MEDICAID | 086670900 | |
| Minnesota | MEDICAID | 34134900 |
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