Individual
PENELOPE JUVRUD SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
14701 VICTOR HUGO BLVD N, HUGO, MN 55038-4561
(952) 853-8800
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
41726
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
024217900
—
MN
01
—
080149404
MEDICARE RAILROAD
MN
Enumeration date
12/07/2005
Last updated
01/04/2023
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