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NPI Code Detail

MEDICARE: TIMOTHY M CASEY MD

MEDICARE:   TIMOTHY M CASEY  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
1207ZP0213XPediatric Pathology Physician34179MN

General Provider Information

NPI Number : 1285626184
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY M CASEY MD
Provider Business Mailing Address
First Line : 2910 CENTRE POINTE DR
Second Line : 35-121A, CHILDRENS HEALTH CARE
City : ROSEVILLE
State : MN
Zip : 55113-1182
Country : US
Telephone Number : 651-855-2109
Fax Number : 651-855-2310
Provider Business Practice Location Address
First Line : 2525 CHICAGO AVE
Second Line : CHILDRENS HOSPITALS AND CLINICS-PATHOLOGY-MPLS
City : MINNEAPOLIS
State : MN
Zip : 55404-4518
Country : US
Telephone Number : 612-813-6280
Fax Number : 612-813-6951
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/17/2005
Last Update Date : 07/08/2007

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