Healthcare Provider Details

I. General information

NPI: 1477696995
Provider Name (Legal Business Name): ABBY CHRISTINE MEYER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ABBY CHRISTINE STRITESKY MD

II. Dates (important events)

Enumeration Date: 02/14/2007
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 CHICAGO AVE S
MINNEAPOLIS MN
55404
US

IV. Provider business mailing address

2525 CHICAGO AVE S
MINNEAPOLIS MN
55404-1292
US

V. Phone/Fax

Practice location:
  • Phone: 612-874-1292
  • Fax:
Mailing address:
  • Phone: 612-874-1292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number54195
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number54195
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: