Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 45627 | MN |
N | 111NI0900X | Internist | 45627 | MN |
N | 207RC0200X | Critical Care Medicine | 45627 | MN |
Y | 207RN0300X | Nephrologist | 45627 | MN |
NPI | 1043276207 |
---|---|
Provider Name | Dr. Abel Ernesto Tello JR. |
First Address | Minneapolis, MN 55425-4516 |
Second Address | St Louis Park, MN 55426-5000 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/04/2006 |
Last Update Date | 14/04/2016 |