Individual
MARY L EZZO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8675 VALLEY CREEK ROAD, WOODBURY, MN 55125-2337
(651) 241-3000
(651) 483-2155
Mailing address
2925 CHICAGO AVENUE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
(612) 262-4194
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
26943
MN
Other
Enumeration date
03/28/2006
Last updated
02/08/2012
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