Provider Demographics
NPI:1740219898
Name:COEN, DEBORAH RUTH (MD)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:RUTH
Last Name:COEN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:10709 WAYZATA BLVD
Mailing Address - Street 2:SUITE 245
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-5509
Mailing Address - Country:US
Mailing Address - Phone:952-746-3330
Mailing Address - Fax:952-545-2652
Practice Address - Street 1:10709 WAYZATA BLVD
Practice Address - Street 2:SUITE 245
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-5509
Practice Address - Country:US
Practice Address - Phone:952-746-3330
Practice Address - Fax:952-545-2652
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN404532084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNG72938Medicare UPIN