Individual
AUTUMN SUE TIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
15350 ENGLISH AVE, APPLE VALLEY, MN 55124-6252
(952) 853-8800
Mailing address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3456
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
74346
MN
Other
Enumeration date
05/09/2021
Last updated
10/08/2024
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