Individual
TERESA MARIE PATANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6500 EXCELSIOR BLVD, ST LOUIS PARK, MN 55426-4702
(952) 993-3282
Mailing address
8170 33RD AVE S # MS 21110Q, BLOOMINGTON, MN 55425-4516
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036.121240
IL
207V00000X
Obstetrics & Gynecology Physician
Primary
69976
MN
207V00000X
Obstetrics & Gynecology Physician
MD60238609
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036121240
STATE LICENSE
IL
01
—
0973PA
REGENCE
WA
05
—
1689838831
—
WA
01
—
284023
LNI
WA
Enumeration date
07/17/2008
Last updated
01/04/2022
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