Individual provider · NPI-1

Dr. Michelle Tiwalade Green Hightower, MD

Family Medicine · Fridley, MN

NPI number1962965236
StatusActive
Last updated in NPPESFeb 2, 2024

Details

NPI
1962965236
Entity type
Individual (NPI-1)
Name
Dr. Michelle Tiwalade Green Hightower
Credential
MD
Sex
Female
Sole proprietor
No
Enumeration date
Apr 12, 2019
Certification date
Feb 2, 2024
Last updated
Feb 2, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine70109MNYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

6341 University Ave Ne
Fridley, MN 55432-4946

Phone 763-586-5844

Mailing address

6341 University Ave Ne
Fridley, MN 55432-4946

Phone 763-586-5844

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