Provider Demographics
NPI:1750432894
Name:REDDING, ABIGAIL E (MD)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:E
Last Name:REDDING
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 VETERANS DR
Mailing Address - Street 2:MINNEAPOLIS VA HEALTCARE SYSTEM
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-2309
Mailing Address - Country:US
Mailing Address - Phone:612-467-2125
Mailing Address - Fax:612-727-5633
Practice Address - Street 1:1 VETERANS DR
Practice Address - Street 2:MINNEAPOLIS VA HEALTHCARE SYSTEM
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2309
Practice Address - Country:US
Practice Address - Phone:612-467-2125
Practice Address - Fax:612-727-5633
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2012-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN492922084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN062173000Medicaid
MN260002666Medicare ID - Type Unspecified
I68513Medicare UPIN