Individual
TIMOTHY J GAVIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6405 FRANCE AVE S, SUITE W440, EDINA, MN 55435-2163
(952) 927-7004
(952) 927-5146
Mailing address
3400 W 66TH ST, SUITE 350, EDINA, MN 55435-2111
(952) 832-0805
(952) 832-5597
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
47505
MN
2086S0129X
Vascular Surgery Physician
Primary
47505
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
181292
UCARE MINNESOTA
MN
01
—
2341371
AMERICA'S PPO
MN
01
—
3700049
MEDICA
MN
01
—
47505
MN LICENSE
MN
05
—
766110000
—
MN
01
—
961901043279
PREFERREDONE
MN
01
—
993N5GA
BLUECROSS/BLUESHIELD MN
MN
01
—
HP50655
HEALTHPARTNERS
MN
01
—
P00217949
MEDICARE RAILROAD
MN
Enumeration date
06/20/2006
Last updated
03/07/2023
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