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NPI Code Detail

MEDICARE: SHEHLA ALAVI MD

MEDICARE: SHEHLA ALAVI 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
12084P0800XPsychiatry Physician41131MN

General Provider Information

NPI Number : 1508838533
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHEHLA ALAVI MD
Provider Business Mailing Address
First Line : 8100 34TH AVE S
Second Line : MC21110Q
City : BLOOMINGTON
State : MN
Zip : 55425-1672
Country : US
Telephone Number : 952-883-7172
Fax Number : 952-883-5395
Provider Business Practice Location Address
First Line : 5625 CENEX DR
Second Line : MAIL STOP 33100A
City : INVER GROVE HEIGHTS
State : MN
Zip : 55077-1724
Country : US
Telephone Number : 651-552-2600
Fax Number : 651-552-2614
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/03/2006
Last Update Date : 07/08/2007

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