Provider Demographics
NPI:1982659272
Name:TOLL, CAROLINE TAINTOR (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:TAINTOR
Last Name:TOLL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 W LAKE ST
Mailing Address - Street 2:STE 201
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-3397
Mailing Address - Country:US
Mailing Address - Phone:612-824-1772
Mailing Address - Fax:
Practice Address - Street 1:1221 W LAKE ST
Practice Address - Street 2:SUITE 201
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55408-2762
Practice Address - Country:US
Practice Address - Phone:612-824-1772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN48323207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN536988600Medicaid
MN536988600Medicaid