Credentials - Acredai

About Me

Taxonomy Radiology, Diagnostic Radiology
Credential M.D.
NPI 1780662783
SSN
Date of Birth
Other Names
Tax ID
Start Date
End Date

Personal Contact

Phone 507-284-2511
Email
Address 200 1ST ST SW
ROCHESTER
MN 559050001

Office Contact

Group
Manager
Phone
Email
Fax
Address

Curriculum Vitae

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Driver's License

Expiry Date: 09/30/2026

Driver's License

Driving License Number

Expiry Date

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Certifications

Professional Healthcare License

State MN

Licence 46915

Valid up to 01/22/2025

State AZ

Licence ghh

Valid up to 01/24/2025

Professional Healthcare License

State

State License number

License status code

License type

Issue date of state license

Expiration date of state license

Add Document

State

State License number

License status code

License type

Issue date of state license

Expiration date of state license

Add Document

DEA License

State CT

DEA Number ggg566

Valid up to 01/31/2025

State DE

DEA Number yy

Valid up to 01/24/2025

DEA License

DEA Number

State

Issue date of DEA License

Expiration date of DEA License

Add Document

DEA Number

State

Issue date of DEA License

Expiration date of DEA License

Add Document

CDS License

State KY

CDS Number gh

Valid up to 01/23/2025

CDS License

CDS Number

License Location

Issue date of CDS License

Expiration date of CDS License

Add Document

Training

Training Name

Training Type

Start Date

End date

Education

Specialty rtt

Training Type Residency

Institution tt

Specialty fgt

Training Type Internship

Institution ghh

Specialty jjj

Training Type Medical School

Institution ggf

Education

Training type

Specialty

Institution Name

Institution Department

Start Date

End date

Program Complete

Address 1

Address 2

City

State

Zip Code

Phone

Fax

URL

Notes

Issue date of CDS License

Expiration date of CDS License

Training type

Specialty

Institution Name

Institution Department

Start Date

End date

Program Complete

Address 1

Address 2

City

State

Zip Code

Phone

Fax

URL

Notes

Issue date of CDS License

Expiration date of CDS License

Training type

Specialty

Institution Name

Institution Department

Start Date

End date

Program Complete

Address 1

Address 2

City

State

Zip Code

Phone

Fax

URL

Notes

Issue date of CDS License

Expiration date of CDS License

Board Certifications

Board Name gh

Valid up to 01/23/2025

Board Certifications

Board Name

Expiration Date

National Medical License

National License number

National Medical License

National License number

Medicare provider

Individual Medicare number

Group Medicare number

Medicare provider

Individual Medicare number

State

Group Medicare number

Group Medicare State

Medicaid provider

Individual Medicare number

Group Medicaid number

Medicaid provider

Individual Medicaid number

Individual Medicaid State

Group Medicaid number

Group Medicaid State

Other Certification

BLS Expiration Date

09/16/2026

Advanced CPR Expiration Date

09/21/2026

Other Certification

BLS Expiration Date

Advanced CPR Expiration Date

Advanced Life Support Expiration Date

Are you certified in the Neonatal Resuscitation Program

Neonatal Resuscitation Program Expiration Date

Are you certified in Advance Life Support in OB

Advanced Life Support in OB Expiration Date

Are you certified in Advanced Trauma Life Support

Advanced Trauma Life Support Expiration Date

Pediatric Advanced Life Support Expiration Date

Advanced Burn Life Support Expiration Date

AADLAND, TIMOTHY

About Me

Personal Contact

Office Contact

Curriculum Vitae

Curriculum Vitae

Driver's License

Driver's License

Certifications

Hi Sunny,