Provider Demographics
NPI:1811301492
Name:PESCH, EVA (MD)
Entity type:Individual
Prefix:
First Name:EVA
Middle Name:
Last Name:PESCH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1865 MONTREAL AVE
Mailing Address - Street 2:
Mailing Address - City:ST. PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-2036
Mailing Address - Country:US
Mailing Address - Phone:320-333-9501
Mailing Address - Fax:
Practice Address - Street 1:1983 SLOAN PLACE
Practice Address - Street 2:STE 1
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55117-2095
Practice Address - Country:US
Practice Address - Phone:651-326-5700
Practice Address - Fax:651-326-5715
Is Sole Proprietor?:No
Enumeration Date:2014-06-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN59531207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine