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General NPI Number Information
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NPI Number | 1326277815
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Entity Type | Individual
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Provider Name | BRANDEN JAMES PFEFFERKORN MD, MPH
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Gender | Male
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Dates
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Enumeration Date | 07/07/2009
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2004 FORD PKWY # MS 35300A
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City | SAINT PAUL
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State | MN
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Zip | 55116-1931
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Country | US
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Telephone | 651-265-0000
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Fax | 651-265-0001
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Provider Business Mailing Address
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Address Line | 8170 33RD AVE S MS 21110Q
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City | BLOOMINGTON
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State | MN
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Zip | 55440-1309
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Country | US
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Telephone | 651-265-0000
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Fax | 651-265-0001
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD60230535
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 62259
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License Number State | MN
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