Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | MT207009 | PA |
N | 111NI0900X | Internist | MT207009 | PA |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 66674 | MN |
NPI | 1720490600 |
---|---|
Provider Name | Dr. Saad Sabah Kubba |
First Address | Rochester, MN 55905-0001 |
Second Address | Rochester, MN 55905-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2014 |
Last Update Date | 25/10/2021 |