Individual
JENNIFER S OBERSTAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Mailing address
909 FULTON ST SE, MINNEAPOLIS, MN 55455-4800
(612) 672-7422
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
44234
MN
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
44234
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
126638100
—
MN
Enumeration date
08/15/2005
Last updated
07/20/2017
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