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NPI Code Detail

MEDICARE: DR. NERSI NIKAKHTAR M.D.

MEDICARE: DR. NERSI NIKAKHTAR 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
1207R00000XInternal Medicine Physician44917-020WI

General Provider Information

NPI Number : 1982620332
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. NERSI NIKAKHTAR M.D.
Provider Business Mailing Address
First Line : 7201 WALKER ST APT 416
Second Line :
City : ST LOUIS PARK
State : MN
Zip : 55426-4185
Country : US
Telephone Number : 612-802-9978
Fax Number : 612-467-1913
Provider Business Practice Location Address
First Line : 1 VETERANS DR
Second Line : 1110
City : MINNEAPOLIS
State : MN
Zip : 55417-2309
Country : US
Telephone Number : 612-467-1964
Fax Number : 612-467-1913
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/15/2006
Last Update Date : 07/08/2007

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