Healthcare Provider Details

I. General information

NPI: 1780431965
Provider Name (Legal Business Name): ANDREW SABIR OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2024
Last Update Date: 04/20/2026
Certification Date: 04/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 S 6TH ST
BRAINERD MN
56401-4529
US

IV. Provider business mailing address

604 E 10TH ST UNIT 2
DULUTH MN
55805-1430
US

V. Phone/Fax

Practice location:
  • Phone: 218-829-2020
  • Fax:
Mailing address:
  • Phone: 218-330-2298
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3938
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: