Provider Demographics
NPI:1629232210
Name:CHELL, JEFFREY WARREN (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:WARREN
Last Name:CHELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3001 BROADWAY ST NE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-2195
Mailing Address - Country:US
Mailing Address - Phone:612-627-5850
Mailing Address - Fax:
Practice Address - Street 1:3001 BROADWAY ST NE
Practice Address - Street 2:SUITE 100
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-2195
Practice Address - Country:US
Practice Address - Phone:612-627-5850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-14
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN29531207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine