Healthcare Provider Details

I. General information

NPI: 1033784152
Provider Name (Legal Business Name): ASMA ADAM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 03/25/2026
Certification Date: 03/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 DELAWARE ST SE, MMC 913
MINNEAPOLIS MN
55455
US

IV. Provider business mailing address

420 DELAWARE ST SE, MMC 913
MINNEAPOLIS MN
55455
US

V. Phone/Fax

Practice location:
  • Phone: 612-624-0990
  • Fax:
Mailing address:
  • Phone: 612-624-0990
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number78813
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number78813
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: