Provider Demographics
NPI:1811966476
Name:WEGSCHEID, TIMOTHY E (DC)
Entity type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:E
Last Name:WEGSCHEID
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4555 ERIN DR
Mailing Address - Street 2:STE 200
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-3432
Mailing Address - Country:US
Mailing Address - Phone:651-330-3900
Mailing Address - Fax:651-330-3901
Practice Address - Street 1:2121 CLIFF DR
Practice Address - Street 2:STE 101
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-3407
Practice Address - Country:US
Practice Address - Phone:651-330-3900
Practice Address - Fax:651-330-3901
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN3427111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN50M08WEOtherBCBS IND: TIN #73-1655643
MN355425200Medicaid
MN492OtherACUPUNCTURE-MN
MN50M07WEOtherBCBS GRP: TIN # 73-1655643
MN50M07WEOtherBCBS GRP: TIN # 73-1655643
MNU77311Medicare UPIN