Individual
DR. PETER BOARDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3931 LOUISIANA AVE S, ST LOUIS PARK, MN 55426-5000
(952) 993-3230
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
48106
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
617667400
—
MN
Enumeration date
04/26/2006
Last updated
07/29/2021
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