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General NPI Number Information
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NPI Number | 1902884117
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Entity Type | Individual
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Provider Name | PETER A BRETZMAN MD
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Gender | Male
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Dates
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Enumeration Date | 01/06/2006
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Last Update Date | 05/23/2024
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Provider Practice Location Address
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Address Line | 4100 MINNESOTA DR. SUITE 310
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City | EDINA
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State | MN
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Zip | 55435-1421
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Country | US
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Telephone | 952-929-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 3500 AMERICAN BLVD W SUITE 300
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City | BLOOMINGTON
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State | MN
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Zip | 55431-4442
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Country | US
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Telephone |
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 38119
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number | 38119
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License Number State | MN
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