Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 62765 | MN |
N | 111NI0900X | Internist | 62765 | MN |
Y | 207RP1001X | Pulmonary Disease | 62765 | MN |
NPI | 1013361161 |
---|---|
Provider Name | Yosuf Walid Subat |
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 | 14/04/2016 |
Last Update Date | 01/10/2020 |