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General NPI Number Information
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NPI Number | 1366492696
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Entity Type | Individual
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Provider Name | CYNTHIA MARIE HUNTIMER M.D., M.P.H.
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Gender | Female
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Dates
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Enumeration Date | 05/10/2006
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Last Update Date | 10/29/2018
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Provider Practice Location Address
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Address Line | 1772 STIEGER LAKE LN STE 220
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City | VICTORIA
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State | MN
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Zip | 55386-7723
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Country | US
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Telephone | 952-443-4600
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Fax | 952-443-4604
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Provider Business Mailing Address
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Address Line | 1321 13TH ST N
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City | SAINT CLOUD
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State | MN
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Zip | 56303-2613
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Country | US
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Telephone | 320-252-5010
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 49154
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License Number State | MN
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