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NPI Code Detail

MEDICARE: DR. FATIMA R. JIWA MBCHB

MEDICARE:  DR. FATIMA R. JIWA  MBCHB
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician43176MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1265409940
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FATIMA R. JIWA MBCHB
Provider Business Mailing Address
First Line : 3366 OAKDALE AVE N
Second Line : #501
City : ROBBINSDALE
State : MN
Zip : 55422-2948
Country : US
Telephone Number : 763-588-0758
Fax Number : 763-588-8505
Provider Business Practice Location Address
First Line : 3366 OAKDALE AVE N
Second Line : #501
City : ROBBINSDALE
State : MN
Zip : 55422-2948
Country : US
Telephone Number : 763-588-0758
Fax Number : 763-588-8505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2006
Last Update Date : 09/22/2011

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Directions to “ DR. FATIMA R. JIWA MBCHB” Practice Location

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