Individual
DANIEL JAMES TIEDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1406 6TH AVE N, ST CLOUD, MN 56303
(320) 656-7020
(320) 255-5714
Mailing address
1200 SIXTH AVE N, CENTRACARE CLINIC, ST CLOUD, MN 56303-2735
(320) 252-5131
(320) 240-2118
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
35523
MN
207RI0011X
Interventional Cardiology Physician
Primary
35523
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1025405
PREFERRED ONE
—
01
—
1119213
ARAZ GROUP/AMERICA'S PPO
—
01
—
119337
U-CARE
—
01
—
2114057
FIRST HEALTH PLAN
—
01
—
2500414
MEDICA HEALTH PLANS
—
01
—
852362200
MEDICAL ASSISTANCE (MA)
—
05
—
852362200
—
MN
01
—
95D80T1
BCBS
—
01
—
HP31427
HEALTH PARTNERS
—
Enumeration date
08/30/2005
Last updated
09/23/2024
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