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General NPI Number Information
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NPI Number | 1053799395
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Entity Type | Individual
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Provider Name | MOONA ARABKHAZAELI MD
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Gender | Female
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Dates
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Enumeration Date | 05/07/2015
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 2603 WHITE BEAR AVE N
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City | MAPLEWOOD
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State | MN
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Zip | 55109-5110
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Country | US
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Telephone | 651-600-3035
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Fax |
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Provider Business Mailing Address
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Address Line | 856 BRENNER AVE
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City | ROSEVILLE
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State | MN
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Zip | 55113-1904
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Country | US
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Telephone | 651-341-6075
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 69292
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 69292
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License Number State | MN
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