Provider Demographics
NPI:1851910889
Name:PAPPAS RICHTER, ELLEN (DO)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:
Last Name:PAPPAS RICHTER
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:
Other - Last Name:PAPPAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4300 MARKETPOINT DR STE 100
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55435-1101
Mailing Address - Country:US
Mailing Address - Phone:952-835-9880
Mailing Address - Fax:
Practice Address - Street 1:4300 MARKETPOINT DR STE 100
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55435-1101
Practice Address - Country:US
Practice Address - Phone:952-835-9880
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MN73013207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program