Provider Demographics
NPI:1699173716
Name:LUM, CALIANN TSUITSIN (MD)
Entity type:Individual
Prefix:DR
First Name:CALIANN
Middle Name:TSUITSIN
Last Name:LUM
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 1:110 BANK ST SE APT 904
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-3903
Mailing Address - Country:US
Mailing Address - Phone:612-378-0514
Mailing Address - Fax:
Practice Address - Street 1:110 BANK ST SE APT 904
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-3903
Practice Address - Country:US
Practice Address - Phone:612-378-0514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-06
Last Update Date:2014-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN22198208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery