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General NPI Number Information
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NPI Number | 1669244059
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Entity Type | Individual
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Provider Name | ARSAM QAZI PA
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Gender | Male
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Dates
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Enumeration Date | 10/27/2023
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Last Update Date | 08/04/2025
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Provider Practice Location Address
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Address Line | 2945 HAZELWOOD ST STE 340
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City | MAPLEWOOD
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State | MN
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Zip | 55109-1241
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Country | US
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Telephone | 651-312-1620
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Fax | 651-999-1902
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Provider Business Mailing Address
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Address Line | 2550 UNIVERSITY AVE W STE 110N
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City | SAINT PAUL
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State | MN
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Zip | 55114-8693
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Country | US
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Telephone | 651-602-5312
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 14717
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License Number State | MN
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