Provider Demographics
NPI:1124045133
Name:ANSAR, AZBER AZHER (MD)
Entity Type:Individual
Prefix:DR
First Name:AZBER
Middle Name:AZHER
Last Name:ANSAR
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:PO BOX 111097
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55111-0097
Mailing Address - Country:US
Mailing Address - Phone:312-560-8799
Mailing Address - Fax:702-920-8976
Practice Address - Street 1:1 VETERANS DR
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417-2309
Practice Address - Country:US
Practice Address - Phone:612-725-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-48969207R00000X
MN1002207R00000X
WAMD00044462207R00000X
SD12135207R00000X
NV10094207R00000X
MI4301077185207R00000X
IN01053327A207R00000X
OH35-078745207R00000X
AZ33994207R00000X
ND9581207R00000X, 207R00000X
WI020-42842207R00000X
NMMD2005-0218207R00000X
UT5825235-1205207R00000X
IL36103564207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH48088Medicare UPIN