Individual
TYLER E LOOMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
775 PRAIRIE CENTER DR STE 300, EDEN PRAIRIE, MN 55344-7317
(952) 428-0300
(952) 428-0150
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
70201
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/29/2019
Last updated
10/16/2023
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