Individual
JOHN EDWARD TIEBEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 2ND ST NE, NEW PRAGUE, MN 56071
(952) 758-4431
Mailing address
301 2ND ST NE, NEW PRAGUE, MN 56071-1709
(952) 587-4431
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
50997
MN
Other
Enumeration date
09/26/2007
Last updated
01/07/2021
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