Healthcare Provider Details

I. General information

NPI: 1376065813
Provider Name (Legal Business Name): ELIZABETH C ENDER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2017
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 E 1ST ST STE 201
DULUTH MN
55805-2215
US

IV. Provider business mailing address

920 E 1ST ST STE 201
DULUTH MN
55805-2215
US

V. Phone/Fax

Practice location:
  • Phone: 218-249-7920
  • Fax:
Mailing address:
  • Phone: 218-249-7920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number71240
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number70127-20
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: