Basic Information
| Provider Information | |||||||||
| NPI: | 1598930331 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PEGLOW | ||||||||
| FirstName: | SARAH | ||||||||
| MiddleName: | REBECCA | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1309 | ||||||||
| Address2: | MAIL STOP 21110Q | ||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554401309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6123415000 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2220 RIVERSIDE AVE | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554541321 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6123415000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2008 | ||||||||
| LastUpdateDate: | 03/29/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RI0200X | 58435 | MN | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease |
No ID Information.