Provider Demographics
NPI:1710037767
Name:SPERLING, JUDITH ANN (DPM)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ANN
Last Name:SPERLING
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:DR
Other - First Name:JUDITH
Other - Middle Name:S
Other - Last Name:HECHTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:5851 DULUTH ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GOLDEN VALLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55422-3955
Mailing Address - Country:US
Mailing Address - Phone:763-546-1718
Mailing Address - Fax:763-546-1943
Practice Address - Street 1:5851 DULUTH ST
Practice Address - Street 2:SUITE 101
Practice Address - City:GOLDEN VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55422-3955
Practice Address - Country:US
Practice Address - Phone:763-546-1718
Practice Address - Fax:763-546-1943
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2016-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN460213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN794025400Medicaid
MN480000327Medicare ID - Type Unspecified
MN794025400Medicaid