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Export Provider Record NPI 1003342130
Abigail Ellen PetersonM.D.
Active
NPI Number1003342130
NPI TypeNPI-1 Individual
SpecialtyInternal Medicine
Provider Details
NPI1003342130
NPI TypeNPI-1 Individual
StatusActive
Enumeration Date2017-05-10
Last Updated2020-05-20
Mailing Address8170 33rd Ave S # Ms 21110q
Bloomington, MN 55425-4516
United States
Phone: (651) 254-3456
📍 View Map
Primary Practice Address640 Jackson St
Saint Paul, MN 55101-2502
United States
Phone: (651) 254-3456
📍 View Map
Taxonomy / Specialty
PrimaryTaxonomy Code & DescriptionStateLicense Number
No390200000X – Student in an Organized Health Care Education/Training Program
Yes207R00000X – Internal MedicineMN67327
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About NPI 1003342130

Abigail Ellen Peterson M.D. is a healthcare provider registered in the CMS NPPES NPI Registry with NPI number 1003342130. The primary specialty listed is Internal Medicine. The provider is located in Saint Paul, MN. This NPI is classified as a Type 1 (Individual) NPI and is currently active. The NPI was first enumerated (assigned) on 2017-05-10. All data is sourced directly from the official CMS NPPES public API and is updated daily.

Frequently Asked Questions

What is NPI 1003342130?

NPI 1003342130 belongs to Abigail Ellen Peterson M.D., a Internal Medicine in Saint Paul, MN. It is a Type 1 Individual NPI registered in the CMS NPPES NPI Registry.

Is NPI 1003342130 active?

The current status of NPI 1003342130 in the NPPES registry is Active. The record was last updated on 2020-05-20.

What specialty is NPI 1003342130?

NPI 1003342130 is classified under the taxonomy Internal Medicine. Taxonomy codes in NPPES are maintained by the National Uniform Claim Committee (NUCC) and identify the provider's type, classification, and specialization.

How do I verify NPI 1003342130?

You can verify NPI 1003342130 at the official CMS NPPES website at npiregistry.cms.hhs.gov or using our free NPI Lookup tool above. All data shown on this page is sourced directly from the official NPPES public API and is updated daily by CMS.

What address is on file for NPI 1003342130?

The primary practice address on file for NPI 1003342130 is 640 Jackson St, Saint Paul, MN 55101-2502. This address is registered in the NPPES system and providers are required to update it within 30 days of any change.

When was NPI 1003342130 issued?

NPI 1003342130 was first issued (enumerated) on 2017-05-10. The NPPES record was last updated on 2020-05-20.

Practice Location Map

Abigail Ellen Peterson is located at 640 Jackson St, Saint Paul, MN. Use the map below to find directions or verify the practice location.

📍 640 Jackson St, Saint Paul, MN 55101-2502  ·  Open in Google Maps ↗

Related Healthcare Providers

The following providers share the same practice location, specialty, or state as Abigail Ellen Peterson. All records sourced from the CMS NPPES registry.

License Information

The following state license numbers are on file in the NPPES registry for NPI 1003342130. For license status verification, contact the relevant state licensing board directly.

Specialty / TaxonomyLicense NumberState
Internal Medicine67327MN
Data Verified from CMS NPPES Last synced: 2026-05-31 · Source: npiregistry.cms.hhs.gov · 45 CFR Part 162