Individual
DR. JUTTA ELLERMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
516 DELAWARE STREET SE, PWB 1ST FL CLINIC 1D UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 273-6004
(612) 273-8459
Mailing address
420 DELAWARE STREET SE, MMC 292 UNIVERSITY OF MINNESOTA PHYSICIANS, MINNEAPOLIS, MN 55455
(612) 626-3345
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
42872
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0097104
—
MT
05
—
0595157
—
IA
01
—
1043942
PREFERRED ONE
MN
01
—
132952
UCARE
MN
01
—
16-02032
MEDICA PRIMARY
MN
01
—
16-03394
MEDICA CHOICE
MN
01
—
2366357
ARAZ
MN
05
—
34623400
—
WI
01
—
614T7EL
BCBS
MN
01
—
HP56036
HEALTPARTNERS
MN
Enumeration date
06/30/2006
Last updated
07/09/2007
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