Individual
DR. TIMOTHY GEORGE LARSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
910 E 26TH ST, SUITE 200, MINNEAPOLIS, MN 55404-4526
(612) 884-6300
(612) 884-6363
Mailing address
910 E 26TH ST, SUITE 200, MINNEAPOLIS, MN 55404-4526
(612) 884-6300
(612) 884-6363
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
38013
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1009049
PREFERRED ONE
MN
01
—
3601103
MEDICA
MN
01
—
7K142LA
BLUE CROSS BLUE SHIELD
MN
05
—
892718900
—
MN
Enumeration date
09/29/2006
Last updated
10/27/2011
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