Individual
MUSTAFA A TIEWALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
825 S. 8TH STREET, SUITE 250, MINNEAPOLIS, MN 55404-1208
(612) 347-5225
Mailing address
701 PARK AVENUE, MINNEAPOLIS, MN 55415-1829
(612) 873-8582
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
52892
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/20/2007
Last updated
10/04/2012
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