Individual
THOM G. A. DAHLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1200 6TH AVE N, CENTRACARE CLINIC, SAINT CLOUD, MN 56303-2735
(320) 252-5131
(320) 255-5714
Mailing address
1200 6TH AVE N, CENTRACARE CLINIC, SAINT CLOUD, MN 56303-2735
(320) 252-5131
(952) 883-5395
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
46342
MN
207RI0011X
Interventional Cardiology Physician
Primary
46342
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
869632200
—
MN
Enumeration date
02/28/2006
Last updated
09/12/2024
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