Individual
DR. SUSAN AMELIA BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
UNIVERSITY OF MINNESOTA PHYSICIANS, 516 DELAWARE STREET SE, PWB FOURTH FLOOR, ROOM 4-100, MINNEAPOLIS, MN 55455
(612) 626-6777
Mailing address
UNIVERSITY OF MINNESOTA PHYSICIANS, 420 DELAWARE STREET SE, MMC 75, MINNEAPOLIS, MN 55455
(612) 624-5965
(612) 626-2993
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
26368
MN
208000000X
Pediatrics Physician
26368
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0052275
—
MT
01
—
100978
UCARE
MN
01
—
1010201
PREFERRED ONE
MN
01
—
12-24753
MEDICA CHOICE
MN
01
—
1270280
MEDICA PRIMARY
MN
05
—
1990358
—
IA
01
—
24479
ARAZ
MN
01
—
2T262BE
BCBS
MN
05
—
30580800
—
WI
05
—
41184394337
—
NE
05
—
666773200
—
MN
01
—
HP12898
HEALTHPARTNERS
MN
Enumeration date
06/22/2006
Last updated
04/20/2012
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