Individual
MARY JENNIFER ABUZZAHAB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
345 SMITH AVE N, SAINT PAUL, MN 55102-2346
(651) 220-6624
(651) 220-6064
Mailing address
5901 LINCOLN DRIVE, CBC-2-REV/PE, EDINA, MN 55436-1611
(952) 992-5624
(952) 992-6917
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
Primary
42796
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
887951600
—
MN
Enumeration date
08/16/2005
Last updated
05/07/2018
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