Provider Demographics
NPI:1487685236
Name:BUDDENSIEK, NEAL C
Entity Type:Individual
Prefix:DR
First Name:NEAL
Middle Name:C
Last Name:BUDDENSIEK
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3623 KREY AVE
Mailing Address - Street 2:
Mailing Address - City:VADNAIS HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-7037
Mailing Address - Country:US
Mailing Address - Phone:651-487-1021
Mailing Address - Fax:
Practice Address - Street 1:ABBOTT NORTHWESTERN HOSPITALIST SERVICE OF THE AMC
Practice Address - Street 2:920 EAST 28TH STREET SUITE # 190
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407
Practice Address - Country:US
Practice Address - Phone:612-863-1893
Practice Address - Fax:612-863-3809
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46680207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine