Individual
DR. SUE V PETZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
UNIVERSITY OF MINNESOTA PHYSICIANS, 606 24TH AVE S, SUITE 300, MINNEAPOLIS, MN 55455-5545
(612) 273-7111
Mailing address
UNIVERSITY OF MINNESOTA PHYSICIANS, 420 DELAWARE ST SE, MMC 395, MINNEAPOLIS, MN 55455-5545
(612) 273-7111
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
LP1118
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00T05PE
BLUE CROSS BLUE SHIELD
—
01
—
1014714
PREFERREDONE
—
01
—
102819
UCARE
—
05
—
39125900
—
WI
01
—
61-32171
MEDICA PRIMARY
—
01
—
768304
ARAZ
—
01
—
HP28968
HP28968
—
Enumeration date
12/19/2006
Last updated
07/08/2007
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