Individual
TIMOTHY J KOELZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1221 NICOLLET AVE, SUITE 600, MINNEAPOLIS, MN 55403-2420
(612) 573-2232
(612) 573-2274
Mailing address
1221 NICOLLET AVE, SUITE 600, MINNEAPOLIS, MN 55403-2420
(612) 573-2232
(612) 573-2274
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
19117
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0247009
PREFERRED ONE
MN
01
—
08829KO
BLUE CROSS
MN
01
—
100700
UCARE
MN
05
—
1942557
—
IA
01
—
22845
AMERICA'S PPO
MN
01
—
297G1KO
BLUE CROSS
MN
01
—
300077289
RAILROAD MEDICARE MN
MN
05
—
30627000
—
WI
05
—
714985000
—
MN
01
—
9214136
DAKOTA CARE
MN
01
—
HP13715
HEALTHPARTNERS
MN
Enumeration date
05/18/2006
Last updated
07/25/2008
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