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General NPI Number Information
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NPI Number | 1093283608
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Entity Type | Individual
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Provider Name | SIDA BAI PA
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Gender | Female
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Dates
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Enumeration Date | 11/13/2018
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 7500 FRANCE AVE S
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City | EDINA
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State | MN
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Zip | 55435-3400
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Country | US
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Telephone | 952-927-6501
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Fax | 833-905-0988
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Provider Business Mailing Address
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Address Line | 3001 METRO DR STE 460
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City | BLOOMINGTON
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State | MN
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Zip | 55425-1548
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Country | US
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Telephone | 651-999-7022
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Fax | 651-999-6970
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 14780
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License Number State | MN
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