Individual
DR. ELLEN ANN SEVENICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3850 PARK NICOLLET AVE, ST. LOUIS PARK, MN 55416
(651) 993-3123
Mailing address
2335 STEWART AVE., 217, ST. PAUL, MN 55116
(651) 698-4522
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
37235
MN
Other
Enumeration date
08/30/2012
Last updated
08/30/2012
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