Basic Information
Provider Information
NPI: 1962675348
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ESSER
FirstName: TIMOTHY
MiddleName: PAUL
NamePrefix: MR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 400 E 3RD ST
Address2: ESSENTIA HEALTH DULUTH CLINIC
City: DULUTH
State: MN
PostalCode: 558051951
CountryCode: US
TelephoneNumber: 2187868364
FaxNumber:  
Practice Location
Address1: 400 E 3RD ST
Address2: ESSENTIA HEALTH DULUTH CLINIC
City: DULUTH
State: MN
PostalCode: 558051951
CountryCode: US
TelephoneNumber: 2187868364
FaxNumber:  
Other Information
ProviderEnumerationDate: 04/08/2008
LastUpdateDate: 08/27/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
390200000X  N Student, Health CareStudent in an Organized Health Care Education/Training Program 
207L00000X250920MAN Allopathic & Osteopathic PhysiciansAnesthesiology 
207L00000X106784MNY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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