MARY JENNIFER ABUZZAHAB (NPI# 1174515274) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174515274 |
| Entity Type | Individual |
| Full Name | MARY JENNIFER ABUZZAHAB |
| Credential | MD |
| Practice Address |
345 Smith Ave N Saint Paul MN 55102-2346 |
| Mailing Address |
5901 Lincoln Drive Cbc-2-rev/pe Edina MN 55436-1611 |
| Practice Telephone | 6512206624 |
| Practice Fax Number | 6512206064 |
| Mailing Telephone | 9529925624 |
| Mailing Fax Number | 9529926917 |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2018-05-07 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0205X |
Pediatrics Specialization: Pediatric Endocrinology |
42796 | MN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 887951600 | 05 |
| Street Address |
345 SMITH AVE N |
| City | SAINT PAUL |
| State | MN |
| Zip Code | 55102-2346 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447883269 | Children's Health Care | Pharmacy | 345 Smith Ave N, Saint Paul, MN 55102-2346 | 2020-02-20 |
| 1134781800 | Maren Vanmieghem | Pharmacist | 345 Smith Ave N, Saint Paul, MN 55102-2346 | 2019-07-02 |
| 1689235467 | Sara E Mcdonnell | Registered Nurse | 345 Smith Ave N, Saint Paul, MN 55102-2346 | 2019-06-24 |
| 1003474420 | Megan A Van Hoorn | Registered Nurse | 345 Smith Ave N, Saint Paul, MN 55102-2346 | 2019-05-31 |
| 1104388644 | Cassandra Hoshor | Nurse Practitioner | 345 Smith Ave N, Saint Paul, MN 55102-2346 | 2019-04-03 |
| 1861968166 | Caitlin Marie Latta | Nurse Practitioner | 345 Smith Ave N, Saint Paul, MN 55102-2346 | 2018-10-15 |
| 1376023309 | Gianna Maria Braband | Pediatrics | 345 Smith Ave N, Saint Paul, MN 55102-2346 | 2018-08-20 |
| 1992285373 | Margaret Sharon Daseler | Pharmacist | 345 Smith Ave N, Saint Paul, MN 55102-2346 | 2018-08-15 |
| 1083191522 | Ikran Omar Hussein | Nurse Practitioner | 345 Smith Ave N, Saint Paul, MN 55102-2346 | 2018-07-27 |
| 1114420783 | Stephen Anthony Delong | Social Worker | 345 Smith Ave N, Saint Paul, MN 55102-2346 | 2018-03-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720623366 | Ning Wu | Acupuncturist | Tcm Health Center, 613 Grand Ave., St. Paul, MN 55102 | 2019-11-07 |
| 1730730615 | Tianwei Guo | Acupuncturist | 613 Grand Avenue, Saint Paul, MN 55102 | 2019-09-23 |
| 1194374850 | Justin Crawford Diehl | Counselor | 976 Juno Avenue, Saint Paul, MN 55102 | 2019-09-05 |
| 1699329169 | Elisabeth Johanna Wurtmann | Genetic Counselor, MS | 310 N Smith Avenue Suite 300, Saint Paul, MN 55102 | 2019-08-01 |
| 1265907083 | Lillia Budd | Nurse Practitioner | 225 Smith Ave N - Suite 400, Mail Route 65400, Saint Paul, MN 55102 | 2018-10-08 |
| 1922505098 | Women of Nations | Substance Abuse Rehabilitation Facility | 73 Leech Street, St. Paul, MN 55102 | 2018-04-06 |
| 1609371939 | Courtney Marie Klinkhammer | Student in an Organized Health Care Education/Training Program | 1026 West Seventh Street, St. Paul, MN 55102 | 2018-03-28 |
| 1427429372 | Compass Pathology and Consulting | Clinical Medical Laboratory | 360 Sherman St Suite 400b, St. Paul, MN 55102 | 2015-10-16 |
| 1639550494 | Daniel Delapp | Speech-Language Pathologist | United Hospital 333 Smith Avenue N, Mail Route 60104, St. Paul, MN 55102 | 2015-06-17 |
| 1124419940 | Suzanne Carl | Speech-Language Pathologist | 360 Colborne Avenue, St. Paul, MN 55102 | 2015-02-16 |
| Find all providers in zip 55102 | ||||
| Taxonomy Code | 2080P0205X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Endocrinology |
| A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831518828 | Luong Doan | Pediatrics | 345 Smith Ave N, Saint Paul, MN 55102-2346 | 2014-04-07 |
| 1457440380 | Christine L Ternand | Pediatrics | 347 Smith Ave N, Children's Hospitals and Clinics of Mn, Saint Paul, MN 55102-2387 | 2006-10-11 |
| 1972595072 | Robert C Mcevoy | Pediatrics | 347 Smith Ave N, Childrens Specialty Clinic-diabetes/endocrinology-stpl, Saint Paul, MN 55102-2387 | 2005-08-16 |
| 1922090034 | Joseph J Sockalosky | Pediatrics | 347 Smith Ave N, Childrens Specialty Clinic-diabetes/endocrinology-stpl, Saint Paul, MN 55102-2387 | 2005-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750368247 | Martha L. Spencer | Pediatrics | 3800 Park Nicolett Blvd., Pediatric Endocrinology, St. Louis Park, MN 55416-2699 | 2005-12-27 |
| 1255323358 | Krishna M Saxena | Pediatrics | Children's Specialty Clinic-diabetes/endocrinology-stpl, 347 North Smith Avenue, St Paul, MN 55102 | 2005-08-16 |
| 1023540473 | Sarah Jackson | Pediatrics | 200 1st St Sw, Rochester, MN 55905-0001 | 2017-04-03 |
| 1265788574 | Anoop Mohamed Iqbal | Pediatrics | 200 1st St Sw, 55905-, Rochester, MN 55905-0001 | 2012-07-24 |
| 1043574569 | Kannan Kasturi | Pediatrics | 400 E 3rd St, Duluth, MN 55805 | 2012-06-28 |
| 1821380007 | Megan Marie Oberle | Pediatrics | 2512 S 7th St, Minneapolis, MN 55454-1404 | 2011-05-06 |
| 1316247323 | Melinda June Rogers Ross Pierce | Pediatrics | 2530 Chicago Ave, Minneapolis, MN 55404-4289 | 2010-10-25 |
| 1578880746 | Eric Morris Bomberg | Pediatrics | 2512 S 7th St, Minneapolis, MN 55454 | 2010-04-28 |
| 1124295761 | Zarlasht Amini | Pediatrics | 200 1st St Sw, Rochester, MN 55905-0001 | 2008-05-13 |
| 1295944932 | Matthew David Wise | Pediatrics | 3800 Park Nicollet Blvd, Minneapolis, MN 55416-2527 | 2007-05-21 |
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| City | SAINT PAUL |
| Zip Code | 55102 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.