Individual
TESS MICHIELUTTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
9555 UPLAND LN N, MAPLE GROVE, MN 55369-4485
(952) 993-1440
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
67174
MN
208000000X
Pediatrics Physician
Primary
67174
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/07/2017
Last updated
10/25/2021
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