MEDICARE: DR. SONYA FUAD M.D.

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	207Q00000X	Family Medicine Physician	36018	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	32G76FU	OTHER	MN	BCBS
2	1011755	OTHER	MN	PREFERRED ONE
3	1053373	OTHER	MN	ARAZ
4	HP18640	OTHER	MN	HEALTHPARTNERS
5	01-04566	OTHER	MN	MEDICA CHOICE
6	104843	OTHER	MN	UCARE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1689605479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SONYA FUAD M.D.

Provider Business Mailing Address
First Line	:	1660 HIGHWAY 100 S
Second Line	:	SUITE 250
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55416-1529
Country	:	US
Telephone Number	:	952-746-5774
Fax Number	:

Provider Business Practice Location Address
First Line	:	1660 HIGHWAY 100 S
Second Line	:	SUITE 250
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55416-1529
Country	:	US
Telephone Number	:	952-746-5774
Fax Number	:

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

Provider Enumeration Date	:	07/06/2006
Last Update Date	:	12/13/2010

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