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NPI Code Detail

MEDICARE: DR. SHABAN NAZARIAN MD

MEDICARE:  DR. SHABAN  NAZARIAN  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
1207RE0101XEndocrinology, Diabetes & Metabolism Physician39394MN

General Provider Information

NPI Number : 1831381854
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHABAN NAZARIAN MD
Provider Business Mailing Address
First Line : 500 S MAPLE ST
Second Line :
City : WACONIA
State : MN
Zip : 55387-1791
Country : US
Telephone Number : 952-442-2191
Fax Number : 952-442-8055
Provider Business Practice Location Address
First Line : 111 HUNDERTMARK RD STE 115N
Second Line :
City : CHASKA
State : MN
Zip : 55318-1584
Country : US
Telephone Number : 952-361-2450
Fax Number : 952-361-2461
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2007
Last Update Date : 07/11/2019

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Directions to “ DR. SHABAN NAZARIAN MD” Practice Location

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