Provider Demographics
NPI:1548468812
Name:TINGER, ELGA OTTLILIA (MD)
Entity type:Individual
Prefix:
First Name:ELGA
Middle Name:OTTLILIA
Last Name:TINGER
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 1:3037 FREMONT AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-2722
Mailing Address - Country:US
Mailing Address - Phone:678-468-9599
Mailing Address - Fax:
Practice Address - Street 1:14700 28TH AVE N
Practice Address - Street 2:SUITE 25
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55447-4835
Practice Address - Country:US
Practice Address - Phone:763-450-5553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-06
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN56129207P00000X
CAA106731207P00000X
WI60023-20207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine