Edward Martel Dennison, MD
Family Medicine in Shoreview, MN. Individual provider (NPI-1).
NPI number1457313587
StatusActive
Last updated in NPPESNov 10, 2020
Details
- NPI
- 1457313587
- Entity type
- Individual (NPI-1)
- Name
- Edward Martel Dennison
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 4, 2006
- Certification date
- Nov 10, 2020
- Last updated
- Nov 10, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | 28499 | MN | Yes |
Practice location
4194 Lexington Ave NShoreview, MN 55126-6106
Phone 651-483-5461
Mailing address
Po Box 43Mr 10809
Minneapolis, MN 55440-0043
Phone 612-262-4813
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