Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080N0001X | Neonatal-Perinatal Doctor | 2004035455 | MO |
Y | 2080N0001X | Neonatal-Perinatal Doctor | 51486 | MN |
N | 2080P0204X | Pediatric Emergency Doctor | 2004035455 | MO |
NPI | 1023034329 |
---|---|
Provider Name | Dr. Nancy M A Fahim |
First Address | Minneapolis, MN 55414 |
Second Address | Minneapolis, MN 55414 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 21/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
206231201 | (05) | MO |
I47330 | (02) |