Individual
TIMOTHY MICHAEL EHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 SIXTH AVE N, ST CLOUD, MN 56303-2735
(320) 252-5131
Mailing address
1200 SIXTH AVE N, ST CLOUD, MN 56303-2735
(320) 252-5131
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
10891
MN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
108091
MN
207RP1001X
Pulmonary Disease Physician
Primary
108091
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
MN
Enumeration date
06/13/2007
Last updated
03/27/2015
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