Individual
TIMOTHY M. HEINLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
MCCANNEL HALL ROOM 100, 2891 2ND AVENUE NORTH STOP 9038, GRAND FORKS, ND 58202-9038
(701) 777-4500
(701) 777-4835
Mailing address
MCCANNEL HALL ROOM 100, 2891 2ND AVENUE NORTH STOP 9038, GRAND FORKS, ND 58202-9038
(701) 777-4500
(701) 777-4835
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5836
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
16444
—
ND
Enumeration date
03/23/2006
Last updated
07/08/2007
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