Healthcare Provider Details

I. General information

NPI: 1124930482
Provider Name (Legal Business Name): MOHD RIZWAN MOHAMAD ANWAR SHAIKH M.B.B.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

401 BROADWAY AVE N APT 431
ROCHESTER MN
55906-6011
US

IV. Provider business mailing address

401 BROADWAY AVE N APT 431
ROCHESTER MN
55906-6011
US

V. Phone/Fax

Practice location:
  • Phone: 507-269-3499
  • Fax:
Mailing address:
  • Phone: 507-269-3499
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License Number35873
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: