Individual
DR. TIMOTHY GERARD BALDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4730 CHICAGO AVE, MINNEAPOLIS, MN 55407-3570
(952) 967-7676
(612) 341-1432
Mailing address
8170 33RD AVE S, MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30056
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31430000
—
WI
Enumeration date
12/07/2005
Last updated
06/09/2022
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