Healthcare Provider Details

I. General information

NPI: 1609139070
Provider Name (Legal Business Name): YUSUF KARRAR M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2012
Last Update Date: 09/03/2021
Certification Date: 09/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3300 OAKDALE AVE N
ROBBINSDALE MN
55422-2926
US

IV. Provider business mailing address

2955 XENIUM LN N STE 40
PLYMOUTH MN
55441-2668
US

V. Phone/Fax

Practice location:
  • Phone: 763-559-2171
  • Fax:
Mailing address:
  • Phone: 763-355-9221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number125060855
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number66503
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number66503
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: