Provider Demographics
NPI:1255308243
Name:JAFRI, IRSHAD H (MD)
Entity Type:Individual
Prefix:
First Name:IRSHAD
Middle Name:H
Last Name:JAFRI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8170 33RD AVE S
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55425-4516
Mailing Address - Country:US
Mailing Address - Phone:651-254-8680
Mailing Address - Fax:
Practice Address - Street 1:640 JACKSON ST
Practice Address - Street 2:MC 11503F
Practice Address - City:ST PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2502
Practice Address - Country:US
Practice Address - Phone:651-254-5529
Practice Address - Fax:651-254-1553
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-08
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN35047207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN378590400Medicaid