Individual
DR. MARY C BLOMBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3850 PARK NICOLLET BLVD, ST LOUIS PARK, MN 55416-2527
(952) 993-3298
Mailing address
6465 WAYZATA BLVD, STE 315, ST LOUIS PARK, MN 55426-1728
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
41144
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
753224500
—
MN
Enumeration date
12/28/2005
Last updated
06/27/2012
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