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Individual

DR. MARLIEKE VAN TYN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
42369
MN
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
42369
MN
208000000X
Pediatrics Physician
Primary
42369
MN
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
42369
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
086670900
MN
05
34134900
WI
Enumeration date
11/01/2006
Last updated
05/06/2008
Update your record

If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.

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