Individual
THOMAS R TETZLAFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4674
SD
2080P0203X
Pediatric Critical Care Medicine Physician
3374
NV
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
4674
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002016073
—
NV
05
—
1790733582
—
MN
05
—
6701390
—
SD
Enumeration date
05/04/2006
Last updated
11/13/2008
Update your record
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