Provider Demographics
NPI:1275574717
Name:MASOOD, MOEEN AHMAD (MB, BS)
Entity Type:Individual
Prefix:DR
First Name:MOEEN
Middle Name:AHMAD
Last Name:MASOOD
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Gender:M
Credentials:MB, BS
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Mailing Address - Street 1:3833 COON RAPIDS BLVD NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:COON RAPIDS
Mailing Address - State:MN
Mailing Address - Zip Code:55433-2697
Mailing Address - Country:US
Mailing Address - Phone:763-427-8320
Mailing Address - Fax:763-302-4338
Practice Address - Street 1:3833 COON RAPIDS BLVD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-2697
Practice Address - Country:US
Practice Address - Phone:763-427-8320
Practice Address - Fax:763-302-4338
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2022-05-18
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Provider Licenses
StateLicense IDTaxonomies
MN374482084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1892388OtherAMERICA'S PPO
WI32286300Medicaid
MNP00028948OtherRAILROAD MEDICARE
MN0500356OtherMEDICA
MN098K9MAOtherBCBS OF MN
MN1275574717Medicaid
MNHP32731OtherHEALTHPARTNERS
MN140304C029OtherUCARE
MN1027027OtherPREFERRED ONE
MN0500356OtherMEDICA
MN1027027OtherPREFERRED ONE