MEDICARE: YOUSIF MURAD

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	183500000X	Pharmacist	118178	MN

General Provider Information

NPI Number	:	1790191260
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YOUSIF MURAD

Provider Business Mailing Address
First Line	:	17756 KENWOOD TRL
Second Line	:
City	:	LAKEVILLE
State	:	MN
Zip	:	55044-9454
Country	:	US
Telephone Number	:	952-898-4505
Fax Number	:

Provider Business Practice Location Address
First Line	:	17756 KENWOOD TRL
Second Line	:
City	:	LAKEVILLE
State	:	MN
Zip	:	55044-9454
Country	:	US
Telephone Number	:	952-898-4505
Fax Number	:

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

Provider Enumeration Date	:	07/06/2014
Last Update Date	:	07/06/2014

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