MEDICARE: HUDA OMAR

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	104100000X	Social Worker
2	1041C0700X	Clinical Social Worker	30235	MN

General Provider Information

NPI Number	:	1689289076
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUDA OMAR

Provider Business Mailing Address
First Line	:	701 4TH AVE S STE 1500
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55415-1637
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 4TH AVE S STE 1500
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55415-1637
Country	:	US
Telephone Number	:	612-341-2060
Fax Number	:

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

Provider Enumeration Date	:	09/11/2020
Last Update Date	:	02/14/2024

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Directions to “ HUDA OMAR ” Practice Location

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