DR. TORE DETLIE (NPI# 1841240686) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841240686 |
| Entity Type | Individual |
| Full Name | DR. TORE DETLIE |
| Credential | M.D. |
| Practice Address |
918 Demont Ave E Maplewood MN 55109-1953 |
| Mailing Address |
11995 Singletree Ln Suite 500 Eden Prairie MN 55344-5347 |
| Practice Telephone | 9525951100 |
| Practice Fax Number | 6122944903 |
| Mailing Telephone | 9525951301 |
| Mailing Fax Number | 6122944903 |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2012-07-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
15435 | NH | Allopathic & Osteopathic Physicians |
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
29546 | MN | Allopathic & Osteopathic Physicians |
| Street Address |
918 DEMONT AVE E |
| City | MAPLEWOOD |
| State | MN |
| Zip Code | 55109-1953 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366063828 | Jodi May Begordis | Registered Nurse | 2586 7th Ave East, Suite 302, North St Paul, MN 55109 | 2020-05-06 |
| 1467917146 | Alejandro Diez Freire | Social Worker | 2468 Germain St, Maplewood, MN 55109 | 2019-02-06 |
| 1679099667 | Rochelle Marie Clarke | Registered Nurse | 2586 7th Ave East Suite 302, North Saint Paul, MN 55109 | 2017-08-21 |
| 1497298210 | Salams Care Residential, LLC | Home Health | 2240 Ide Ct, Maplewood, MN 55109 | 2016-11-28 |
| 1093199630 | Garry Allen | Psychologist | 2345 Ariel St North Mail Stop 13601a, Maplewood, MN 55109 | 2015-07-14 |
| 1700264751 | Matthew Seng Thao | Student in an Organized Health Care Education/Training Program | 1470 Gervais Ave, Maplewood, MN 55109 | 2015-05-11 |
| 1326458340 | Chong Chang | Counselor | 1705 Cope Ave E Ste I, Maplewood, MN 55109 | 2014-04-29 |
| 1619396488 | Leah Anne Downey | Occupational Therapist | 2399 Ariel St. N., Children's Theraplay, LLC, Maplewood, MN 55109 | 2014-04-09 |
| 1356765440 | Group Health Plan, Inc | Clinic/Center | 2520 12th Ave E, North St Paul, MN 55109 | 2014-02-10 |
| 1336560275 | Veneman Dental Care, Pa | Dentist | 1774 Cope Ave, Suite 110, Maplewood, MN 55109 | 2013-12-19 |
| Find all providers in zip 55109 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164604146 | Maplewood Imaging Center LLC | Radiology | 2945 Hazelwood St Ste 110, Maplewood, MN 55109-1242 | 2007-11-30 |
| 1912952433 | Uvadee Chaibongsai | Radiology | 2130 Millburn Avenue, Maplewood, NJ 07040 | 2006-05-23 |
| 1033162177 | Minnesota Medical Scanning Corporation | Radiology | 1860 Beam Avenue, Maplewood, MN 55109 | 2006-05-18 |
| 1124056080 | Medical Scanning Consultants Pa | Radiology | 1860 Beam Avenue, Maplewood, MN 55109 | 2006-06-29 |
| 1710932918 | Sujata K. Jhaveri | Radiology | 2130 Millburn Avenue, Maplewood, NJ 07040 | 2006-05-24 |
| 1902851421 | Hillel J. Karp | Radiology | 2130 Millburn Avenue, Maplewood, NJ 07040 | 2006-05-23 |
| 1356396873 | Millburn Medical Imaging, Pa | Radiology | 2130 Millburn Avenue, Maplewood, NJ 07040 | 2006-05-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457967234 | Central Imaging LLC | Radiology | 3351 Roosevelt Rd, Saint Cloud, MN 56301-6270 | 2020-09-17 |
| 1053930578 | Dmitriy Shchegolev | Radiology | 14346 Wilson Dr, Eden Prairie, MN 55347-4179 | 2020-04-14 |
| 1306333109 | John Warren Kirby | Radiology | 200 1st St Sw # 507284, Rochester, MN 55905 | 2018-04-17 |
| 1861904765 | Stephanie Dykema | Radiology | 6809 Sandlewood Rd, Woodbury, MN 55125-2175 | 2017-10-31 |
| 1609392349 | Rai Keystone Imaging Services, LLC | Radiology | 5775 Wayzata Blvd Ste 400, St Louis Park, MN 55416-1271 | 2017-08-15 |
| 1235687088 | Jeffery E. Illman | Radiology | 1082 Southern Ridge Dr Sw, Rochester, MN 55902-1854 | 2016-09-21 |
| 1407226582 | Keith W. Johnson | Radiology | 450 Bayview Dr, Roseville, MN 55113-6907 | 2015-10-01 |
| 1164765822 | Robben Andrew Schat | Radiology | 420 Delaware St Se - Mmc 292, Minneapolis, MN 55455-0341 | 2013-04-01 |
| 1326363102 | Gilda Boroumand | Radiology | 1901 Irving Ave S, Minneapolis, MN 55403-2824 | 2010-04-05 |
| 1477880276 | Siobhan Moira Flanagan | Radiology | Mmc 292,420 Delaware Street Se, University of Minnesota Department of Radiology, Minneapolis, MN 55455 | 2009-11-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. TORE DETLIE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.