Healthcare Provider Details

I. General information

NPI: 1770861197
Provider Name (Legal Business Name): NADEEM AQEEL KHAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2011
Last Update Date: 08/07/2025
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 E 28TH ST
MINNEAPOLIS MN
55407-1139
US

IV. Provider business mailing address

601 ELMWOOD AVENUE BOX 679-A
ROCHESTER NY
14642
US

V. Phone/Fax

Practice location:
  • Phone: 612-863-4000
  • Fax:
Mailing address:
  • Phone: 585-275-4290
  • Fax: 585-473-1573

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number57421
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number57421
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: