Individual
ELLEN AMY OVERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 273-3000
Mailing address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
60094
MN
207R00000X
Internal Medicine Physician
A152846
CA
208000000X
Pediatrics Physician
60094
MN
208000000X
Pediatrics Physician
A152846
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/21/2014
Last updated
06/21/2023
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