Basic Information
| Provider Information | |||||||||
| NPI: | 1124088315 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | RUMSEY | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1026 7TH ST W | ||||||||
| Address2: | |||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551023828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512411000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1026 7TH ST W | ||||||||
| Address2: | |||||||||
| City: | SAINT PAUL | ||||||||
| State: | MN | ||||||||
| PostalCode: | 551023828 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6512411000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/23/2006 | ||||||||
| LastUpdateDate: | 10/26/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 22242 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | HP96369 | 01 | MN | HEALTH PARTNERS | OTHER | 290583300 | 05 | MN | MEDICAID | 01-07915 | 01 | MN | MEDICA | OTHER | 23Y93RU | 01 | MN | BCBS | OTHER | 102244 | 01 | MN | UCARE | OTHER |