MEDICARE: DR. CHARLES ALBIN TIETZ MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	15922	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	77163TI	OTHER	MN	BCBS
2	07-02849	OTHER	MN	MEDICA

General Provider Information

NPI Number	:	1861499584
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHARLES ALBIN TIETZ MD

Provider Business Mailing Address
First Line	:	307 1ST ST S
Second Line	:	STE 108
City	:	VIRGINIA
State	:	MN
Zip	:	55792-2696
Country	:	US
Telephone Number	:	218-749-8326
Fax Number	:	218-749-8608

Provider Business Practice Location Address
First Line	:	307 1ST ST S
Second Line	:	STE 108
City	:	VIRGINIA
State	:	MN
Zip	:	55792-2696
Country	:	US
Telephone Number	:	218-749-8326
Fax Number	:	218-749-8608

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	01/14/2008

Similar Medicare Providers

1831149046 — DR. KATHLEEN SULENTICH M.D./F.A.C.O.G.
Practice Location Address:

307 1ST ST S , SUITE 112
VIRGINIA, MN
55792-2696

Practice Phone: 218-741-6221
Practice Fax: 218-741-2550

1881798585 — KATHLEEN SULENTICH MD FACOG LTD
Practice Location Address:

307 1ST ST S , SUITE 112
VIRGINIA, MN
55792-2696

Practice Phone: 218-741-6221
Practice Fax: 218-741-2550

1316158173 — CHARLES A TIETZ MD FACOG LTD
Practice Location Address:

307 1ST ST S , STE108
VIRGINIA, MN
55792-2696

Practice Phone: 218-749-8326
Practice Fax: 218-749-8608

1609041755 — MR. VERNON LEE HANSON LICSW
Practice Location Address:

307 1ST ST S
VIRGINIA, MN
55792-2696

Practice Phone: 218-749-9789
Practice Fax:

1083617120 — ESSENTIA HEALTH VIRGINIA, LLC
Practice Location Address:

901 9TH ST N
VIRGINIA, MN
55792-2325

Practice Phone: 218-741-3340
Practice Fax: 218-749-9427

1396748034 — ESSENTIA HEALTH VIRGINIA, LLC
Practice Location Address:

901 9TH ST N
VIRGINIA, MN
55792-2348

Practice Phone: 218-741-3340
Practice Fax: 218-749-9427

Directions to “ DR. CHARLES ALBIN TIETZ MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.