Individual
SHANNON WELTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
6401 FRANCE AVE S, EDINA, MN 55435-2104
(952) 924-5000
Mailing address
820 BROCKTON LN N, PLYMOUTH, MN 55447-3343
(612) 720-8885
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
68273
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/04/2009
Last updated
01/31/2024
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