Healthcare Provider Details

I. General information

NPI: 1548235872
Provider Name (Legal Business Name): MARIE ELIZABETH BRIDEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 10/22/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 BARRIE RD
EDINA MN
55435-2305
US

IV. Provider business mailing address

6525 BARRIE RD
EDINA MN
55435-2305
US

V. Phone/Fax

Practice location:
  • Phone: 952-915-6000
  • Fax: 952-915-6100
Mailing address:
  • Phone: 952-915-6000
  • Fax: 952-915-6100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number28680
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: