Provider Demographics
NPI:1417988510
Name:IKRAMUDDIN, SAYEED (MD)
Entity Type:Individual
Prefix:DR
First Name:SAYEED
Middle Name:
Last Name:IKRAMUDDIN
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:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:420 DELAWARE ST SE, MMC 195
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-6666
Mailing Address - Fax:
Practice Address - Street 1:516 DELAWARE ST. SE
Practice Address - Street 2:PWB FIRST FLOOR, CLINIC 1E
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-626-6666
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2012-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN44194208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0547877Medicaid
17-00026OtherMEDICA-PRIMARY
HP35550OtherHEALTHPARTNERS
1029798OtherPREFERREDONE
17-00671OtherMEDICA-CHOICE
1497784OtherARAZ
MN400027700Medicaid
140908OtherUCARE
MN162A6IKOtherBLUE CROSS BLUE SHIELD
WI34161000Medicaid
G62193Medicare UPIN
020050630Medicare ID - Type UnspecifiedRAIL ROAD MEDICARE
MN400027700Medicaid