Individual
THOMAS STEALEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6545 FRANCE AVE S, SUITE 400, EDINA, MN 55435-2131
(952) 920-9191
(952) 920-0232
Mailing address
6545 FRANCE AVE S, SUITE 400, EDINA, MN 55435-2131
(952) 920-9191
(952) 920-0232
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
23647
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1201801
MEDICA
MN
01
—
16734ST
BLUE CROSS BLUE SHIELD
MN
01
—
CP9020830004
PREFERRED ONE
—
Enumeration date
07/27/2006
Last updated
07/08/2007
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