Individual
DR. TORE DETLIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
918 DEMONT AVE E, MAPLEWOOD, MN 55109-1953
(952) 595-1100
(612) 294-4903
Mailing address
11995 SINGLETREE LN, SUITE 500, EDEN PRAIRIE, MN 55344-5347
(952) 595-1301
(612) 294-4903
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
15435
NH
2085R0202X
Diagnostic Radiology Physician
Primary
29546
MN
Other
Enumeration date
05/11/2006
Last updated
07/19/2012
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