Healthcare Provider Details

I. General information

NPI: 1861067209
Provider Name (Legal Business Name): HAMZA HANIF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2021
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date: 03/29/2023
Reactivation Date: 06/20/2023

III. Provider practice location address

200 1ST ST SW
ROCHESTER MN
55905-0001
US

IV. Provider business mailing address

PO BOX 860912 PROVIDER ENROLLMENT RST
MINNEAPOLIS MN
55486-0912
US

V. Phone/Fax

Practice location:
  • Phone: 507-284-2511
  • Fax:
Mailing address:
  • Phone: 507-284-2511
  • Fax: 507-284-0702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number82096
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: