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Individual

THOMAS MATTHEW ZIEBARTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
507 W DOUGHTY ST, LAKE CITY, MN 55041-1500
(651) 345-2350
(651) 345-2238
Mailing address
507 W DOUGHTY ST, LAKE CITY, MN 55041-1500
(651) 345-2350
(651) 345-2238

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37579
MN
208D00000X
General Practice Physician
37579
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
456723400
MN
Enumeration date
12/20/2005
Last updated
08/18/2016
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