MEDICARE: MR. MICHAEL CHARLES TRESSLER M.D

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	207R00000X	Internal Medicine Physician	53843	MN
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	53843	MN

General Provider Information

NPI Number	:	1255595526
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MICHAEL CHARLES TRESSLER M.D

Provider Business Mailing Address
First Line	:	6498 WHITE OAK ROAD
Second Line	:
City	:	LINO LAKES
State	:	MN
Zip	:	55038
Country	:	US
Telephone Number	:	612-741-8004
Fax Number	:	636-228-2251

Provider Business Practice Location Address
First Line	:	6498 WHITE OAK ROAD
Second Line	:
City	:	LINO LAKES
State	:	MN
Zip	:	55038
Country	:	US
Telephone Number	:	612-741-8004
Fax Number	:	636-228-2251

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

Provider Enumeration Date	:	07/15/2008
Last Update Date	:	05/24/2022

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