Individual
DR. INGRID ABOLS-MANTYH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
675 E NICOLLET BLVD, SUITE 100, BURNSVILLE, MN 55337-6749
(952) 435-8516
(763) 302-4336
Mailing address
501 E NICOLLET BLVD, STE 100, BURNSVILLE, MN 55337-6772
(952) 435-8516
(763) 302-4336
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
29023
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0265035
PREFERRED ONE
MN
01
—
0517222
MEDICA
MN
01
—
100274C029
UCARE
MN
01
—
130004283
RAILROAD MEDICARE
MN
01
—
19364AB
BCBS OF MN
MN
01
—
22665
AMERICA'S PPO
MN
05
—
31534800
—
WI
05
—
9040978000
—
MN
01
—
HP12761
HEALTHPARTNERS
MN
Enumeration date
05/19/2006
Last updated
03/04/2019
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