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NPI Code Detail

MEDICARE: AZRA DURAKOVIC MD

MEDICARE: AZRA DURAKOVIC 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
1207Q00000XFamily Medicine Physician48876MN

General Provider Information

NPI Number : 1871572099
Entity Type Code : Individual
Provider Name (Legal Business Name) : AZRA DURAKOVIC MD
Provider Business Mailing Address
First Line : 611 E FAIRVIEW AVE
Second Line :
City : OLIVIA
State : MN
Zip : 56277-1397
Country : US
Telephone Number : 320-523-1261
Fax Number :
Provider Business Practice Location Address
First Line : 4300 EDGEWOOD DR NE
Second Line :
City : SAINT MICHAEL
State : MN
Zip : 55376-4588
Country : US
Telephone Number : 763-744-4000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/16/2006
Last Update Date : 11/13/2015

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Directions to “ AZRA DURAKOVIC MD” Practice Location

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