Individual
DAVID J TILSTRA
Active
Individual
DAVID J TILSTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
37920
MN
208000000X
Pediatrics Physician
37920
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
074814500
MEDICAL ASSISTANCE
—
01
—
1008055
PREFERRED ONE
—
01
—
110417
UCARE
—
01
—
1200086
MEDICA HEALTH PLANS
—
01
—
2089340
FIRST HEALTH PLAN
—
01
—
51A44TI
BLUE CROSS BLUE SHIELD
—
01
—
763003
ARAZ GROUP AMERICAS PPO
—
01
—
7713350
SOUTH DAKOTA MA
—
01
—
HP25528
HEALTH PARTNERS
—
Enumeration date
11/08/2005
Last updated
12/13/2011
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