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NPI Code Detail

MEDICARE: ALI JAMAL SHIREH

MEDICARE: ALI JAMAL SHIREH
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
11041C0700XClinical Social Worker
21041C0700XClinical Social Worker25175MN

General Provider Information

NPI Number : 1730735119
Entity Type Code : Individual
Provider Name (Legal Business Name) : ALI JAMAL SHIREH
Provider Business Mailing Address
First Line : 300 S 6TH ST
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55487-0999
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2355 HIGHWAY 36 W STE 419
Second Line :
City : ROSEVILLE
State : MN
Zip : 55113-3902
Country : US
Telephone Number : 651-276-1535
Fax Number : 651-666-1211
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/12/2019
Last Update Date : 01/07/2025

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Directions to “ ALI JAMAL SHIREH ” Practice Location

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