Provider Demographics
NPI:1063859288
Name:KASSIR, MOHAMMAD ABBAS (MD)
Entity Type:Individual
Prefix:
First Name:MOHAMMAD
Middle Name:ABBAS
Last Name:KASSIR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 METRO BLVD
Mailing Address - Street 2:STE 400
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55439-3010
Mailing Address - Country:US
Mailing Address - Phone:612-573-2200
Mailing Address - Fax:612-573-2274
Practice Address - Street 1:7505 METRO BLVD
Practice Address - Street 2:STE 400
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55439-3010
Practice Address - Country:US
Practice Address - Phone:612-573-2200
Practice Address - Fax:612-573-2274
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2019-05-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1533372085D0003X
MN650372085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No2085D0003XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Neuroimaging