Individual
SUSAN G VAN PELT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
303 CATLIN ST, BUFFALO HOSPITAL, BUFFALO, MN 55313
(763) 684-7500
(763) 684-7152
Mailing address
5435 FELTL RD, MINNETONKA, MN 55343-7983
(952) 835-9880
(952) 857-1554
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31741
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305897200
—
MN
01
—
31741
MEDICAL LICENSE
MN
Enumeration date
03/07/2006
Last updated
06/18/2010
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