Provider Demographics
NPI:1508952623
Name:ABELER, STEPHEN RICHARD (DC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:RICHARD
Last Name:ABELER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2705 BUNKER LAKE BLVD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:ANDOVER
Mailing Address - State:MN
Mailing Address - Zip Code:55304
Mailing Address - Country:US
Mailing Address - Phone:763-754-2500
Mailing Address - Fax:763-755-3852
Practice Address - Street 1:2705 BUNKER LAKE BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:ANDOVER
Practice Address - State:MN
Practice Address - Zip Code:55304
Practice Address - Country:US
Practice Address - Phone:763-754-2500
Practice Address - Fax:763-755-3852
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2048111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN60G38ABOtherBLUE CROSS BLUE SHIELD
MNP00222142OtherMEDICARE RAILROAD
MN60G38ABOtherBLUE CROSS BLUE SHIELD