Provider Demographics
NPI:1558317925
Name:NEUROSURGICAL ASSOCIATES, LTD.
Entity Type:Organization
Organization Name:NEUROSURGICAL ASSOCIATES, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:GAMAL
Authorized Official - Last Name:NAGIB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-871-7278
Mailing Address - Street 1:800 E 28TH ST
Mailing Address - Street 2:305 PIPER BLDG.
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-3723
Mailing Address - Country:US
Mailing Address - Phone:612-871-7278
Mailing Address - Fax:612-879-7189
Practice Address - Street 1:800 E 28TH ST
Practice Address - Street 2:305 PIPER BLDG.
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-3723
Practice Address - Country:US
Practice Address - Phone:612-871-7278
Practice Address - Fax:612-879-7189
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN291174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN12483NEOtherBLUE CROSS BLUE SHIELD
WI32719700Medicaid
MNC0039014Medicare ID - Type Unspecified