Provider Demographics
NPI:1235469594
Name:SZABAD, ANDREJ JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANDREJ
Middle Name:JOHN
Last Name:SZABAD
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 1:1615 E RIVER TER
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55414-3676
Mailing Address - Country:US
Mailing Address - Phone:612-338-8145
Mailing Address - Fax:612-338-8145
Practice Address - Street 1:1615 E RIVER TER
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-3676
Practice Address - Country:US
Practice Address - Phone:612-338-8145
Practice Address - Fax:612-338-8145
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-10
Last Update Date:2010-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN26023208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice