Provider Demographics
NPI:1780677849
Name:LILLEMOE, TAMERA JENSEN (MD)
Entity Type:Individual
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First Name:TAMERA
Middle Name:JENSEN
Last Name:LILLEMOE
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Gender:F
Credentials:MD
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Mailing Address - Street 1:2800 10TH AVE S STE 2200
Mailing Address - Street 2:HOSPITAL PATHOLOGY ASSOC
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1311
Mailing Address - Country:US
Mailing Address - Phone:612-767-8370
Mailing Address - Fax:612-767-8376
Practice Address - Street 1:2800 10TH AVE S STE 2200
Practice Address - Street 2:HOSPITAL PATHOLOGY ASSOC
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1311
Practice Address - Country:US
Practice Address - Phone:612-767-8370
Practice Address - Fax:612-767-8376
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2020-08-26
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Provider Licenses
StateLicense IDTaxonomies
MN30142207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology