Provider Demographics
NPI:1184691362
Name:TVEDTE, STEVEN TIMOTHY (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:TIMOTHY
Last Name:TVEDTE
Suffix:
Gender:M
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:PO BOX 39478
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-0478
Mailing Address - Country:US
Mailing Address - Phone:952-921-0450
Mailing Address - Fax:952-835-0999
Practice Address - Street 1:5409 MOUNT NORMANDALE CURV
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437-1019
Practice Address - Country:US
Practice Address - Phone:952-921-0450
Practice Address - Fax:952-835-0999
Is Sole Proprietor?:No
Enumeration Date:2006-03-07
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN23936207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN23936OtherMN MEDICAL LICENSE
IA20212OtherIOWA MEDICAL LICENSE
MN351783700Medicaid
MN351783700Medicaid
IA20212OtherIOWA MEDICAL LICENSE