Individual
PAMELA GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
500 OSBORNE RD NE, SUITE 255, FRIDLEY, MN 55432-2765
(763) 786-6011
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-5000
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
34005
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143202800
—
MN
Enumeration date
04/12/2006
Last updated
11/10/2020
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