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General NPI Number Information
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NPI Number | 1336215987
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Entity Type | Organization
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Legal Business Name | UNIVERSITY OF MINNESOTA
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 580 RICE ST
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City | SAINT PAUL
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State | MN
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Zip | 55103-2148
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Country | US
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Telephone | 651-227-6551
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Fax |
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Provider Business Mailing Address
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Address Line | 225 EAST COUNTY ROAD B2, APT # 269
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City | LITTLE CANADA
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State | MN
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Zip | 55117
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Country | US
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Telephone | 651-486-4914
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Fax |
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Authorized Official
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Title or Position | FAMILY PHYSICIAN
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Name | DR. AZIZA SHIREEN
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Credential | M.D.
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Telephone | 651-227-6551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 282N00000X
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Taxonomy Name | General Acute Care Hospital
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License Number | 49235
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License Number State | MN
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