Provider Demographics
NPI:1295095784
Name:PFANNES, LORETTA V (MD)
Entity type:Individual
Prefix:DR
First Name:LORETTA
Middle Name:V
Last Name:PFANNES
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:8170 33RD AVE S # MS 21110Q
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:952-883-7172
Mailing Address - Fax:
Practice Address - Street 1:420 DELAWARE ST SE
Practice Address - Street 2:MMC 284
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-626-8199
Practice Address - Fax:612-625-3238
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-18
Last Update Date:2018-08-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN57298207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine