Individual
BRETT WALTER TETEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
17 WEST EXCHANGE ST, #500, ST PAUL, MN 55102
(651) 232-4200
(651) 232-4119
Mailing address
17 WEST EXCHANGE ST, #500, ST PAUL, MN 55102
(651) 232-4200
(651) 232-4119
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
41744
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
41744
STATE MEDICAL LICENSE
MN
05
—
713822900
—
MN
Enumeration date
10/12/2006
Last updated
04/23/2012
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