Individual
TIMOTHY JOHN GLENDENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
333 SMITH AVE N, SAINT PAUL, MN 55102-2344
(651) 241-2100
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC ANESTHESIOLOGY, MILWAUKEE, WI 53226-4874
(414) 266-3560
(414) 266-6092
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
61584
WI
207L00000X
Anesthesiology Physician
Primary
61630
MN
207LP3000X
Pediatric Anesthesiology Physician
61584
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730455908
—
WI
Enumeration date
03/31/2012
Last updated
03/17/2018
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