Provider Demographics
NPI:1235340894
Name:DARABI, KAMRUZ (MD)
Entity Type:Individual
Prefix:DR
First Name:KAMRUZ
Middle Name:
Last Name:DARABI
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 1:582 CHERRY DR
Mailing Address - Street 2:
Mailing Address - City:WACONIA
Mailing Address - State:MN
Mailing Address - Zip Code:55387-4578
Mailing Address - Country:US
Mailing Address - Phone:952-395-6850
Mailing Address - Fax:952-395-6870
Practice Address - Street 1:582 CHERRY DR
Practice Address - Street 2:
Practice Address - City:WACONIA
Practice Address - State:MN
Practice Address - Zip Code:55387-4578
Practice Address - Country:US
Practice Address - Phone:952-395-6850
Practice Address - Fax:952-395-6870
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2021-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN55882207ND0101X, 207ND0900X, 207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
No207ND0900XAllopathic & Osteopathic PhysiciansDermatologyDermatopathology