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Individual
TIMOTHY BACHENBERG
Active
Individual
TIMOTHY BACHENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34448
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-13050
MEDICA
MN
01
—
06Q36BA
BLUE CROSS
MN
05
—
06Q36BA
—
MN
05
—
120541
—
MN
01
—
23346
SIOUX VALLEY
MN
01
—
604566
ARAZ
MN
01
—
7293
AVERA
MN
05
—
762580400
—
MN
05
—
983395
—
IA
01
—
A021
CHAMPUS
MN
01
—
HP29866
HEALTHPARTNERS
MN
01
—
MH9041001734
PREFERREDONE
MN
Enumeration date
12/06/2005
Last updated
12/19/2013
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