MEDICARE: KAMRAN DARABI MD

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
1	207RH0003X	Hematology & Oncology Physician	56298	MN
2	207RH0003X	Hematology & Oncology Physician	2016-02270	NC
3	207RH0000X	Hematology (Internal Medicine) Physician	ME159623	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1508074402
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMRAN DARABI MD

Provider Business Mailing Address
First Line	:	320 EAST MAIN STREET
Second Line	:
City	:	CROSBY
State	:	MN
Zip	:	56441
Country	:	US
Telephone Number	:	218-546-7000
Fax Number	:	218-546-4400

Provider Business Practice Location Address
First Line	:	3503 E FRONTAGE RD
Second Line	:
City	:	TAMPA
State	:	FL
Zip	:	33607-1742
Country	:	US
Telephone Number	:	813-586-8187
Fax Number	:	813-321-6998

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/21/2007
Last Update Date	:	05/11/2023

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