Provider Demographics
NPI:1528354065
Name:ESPENSON, SUZANNE MARIE (MD)
Entity type:Individual
Prefix:
First Name:SUZANNE
Middle Name:MARIE
Last Name:ESPENSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8100 W 78TH ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-2516
Mailing Address - Country:US
Mailing Address - Phone:952-914-8100
Mailing Address - Fax:952-914-8101
Practice Address - Street 1:8100 W 78TH ST
Practice Address - Street 2:SUITE 100
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-2516
Practice Address - Country:US
Practice Address - Phone:952-914-8100
Practice Address - Fax:952-914-8101
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2020-11-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN55272207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine