Provider Demographics
NPI:1376719724
Name:FELTON, GRETCHEN (MD MPH)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:
Last Name:FELTON
Suffix:
Gender:F
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4627 CHATELAIN TERRACE
Mailing Address - Street 2:
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-5236
Mailing Address - Country:US
Mailing Address - Phone:763-377-9217
Mailing Address - Fax:
Practice Address - Street 1:4627 CHATELAIN TERRACE
Practice Address - Street 2:
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-5236
Practice Address - Country:US
Practice Address - Phone:763-377-9217
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-05-06
Last Update Date:2008-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN39559208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics