NPI 1376500389 · live from the CMS NPI Registry
Peter Boardman, M.D.
Psychiatry & Neurology, Neurology in St Louis Park, MN. National Provider Identifier 1376500389, active.
NPI record
| NPI | 1376500389 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Psychiatry & Neurology, Neurology 2084N0400X |
| Practice location | 3931 Louisiana Ave S, St Louis Park, MN 55426 |
| Practice phone | 952-993-3230 |
| Mailing address | 8170 33rd Ave S # Ms 21110q, Bloomington, MN 55425 |
| Enumerated | April 26, 2006 |
| Last updated | July 29, 2021 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Psychiatry & Neurology, Neurology primary | 2084N0400X | 48106 (MN) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.