Individual
TIMOTHY BACHENBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 MEDICAL CENTER DR, FAIRMONT, MN 56031-4575
(507) 238-8555
Mailing address
800 MEDICAL CENTER DR, PO BOX 800, FAIRMONT, MN 56031-4575
(507) 238-8555
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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