Individual
ABIGAIL ELLEN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-3456
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
(651) 254-3456
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
67327
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/10/2017
Last updated
05/20/2020
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