Individual
BRENDA LOUISE WILCOX ABRAHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2500 COMO AVENUE, ST PAUL, MN 55108-1460
(651) 641-6200
(651) 641-6295
Mailing address
8170 33RD AVE S # MS 21110Q, MINNEAPOLIS, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
33664
MN
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
33664
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
384378500
—
MN
Enumeration date
02/01/2006
Last updated
06/14/2023
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