Basic Information
| Provider Information | |||||||||
| NPI: | 1285655407 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STUDER | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 20 CENTENNIAL DR 84 W | ||||||||
| Address2: | |||||||||
| City: | NEW YORK MILLS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 56567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2183851800 | ||||||||
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| Practice Location | |||||||||
| Address1: | 20 CENTENNIAL 84 DR W | ||||||||
| Address2: | |||||||||
| City: | NEW YORK MILLS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 56567 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2183851800 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/22/2006 | ||||||||
| LastUpdateDate: | 12/02/2011 | ||||||||
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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 | 40521 | MN | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.