Provider Demographics
NPI:1679000426
Name:CHESSIDY, ADRIANNE SHOSHANA (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:ADRIANNE
Middle Name:SHOSHANA
Last Name:CHESSIDY
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:ADRIANNE
Other - Middle Name:
Other - Last Name:CHESSER, CHESSER-FRIDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5320 HYLAND GREENS DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437-3934
Mailing Address - Country:US
Mailing Address - Phone:952-993-2400
Mailing Address - Fax:
Practice Address - Street 1:233 GRAND AVE
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-2331
Practice Address - Country:US
Practice Address - Phone:651-241-5200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2024-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN66908207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine