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Individual

LISA PENG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
800 E 28TH ST, MINNEAPOLIS, MN 55407-3723
(651) 635-9173
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000

Taxonomy

Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
68082
MN
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
77055-21
WI
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/09/2019
Last updated
12/22/2023
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