Provider Demographics
NPI:1649409665
Name:SAHA, INDRANI (MD)
Entity Type:Individual
Prefix:MS
First Name:INDRANI
Middle Name:
Last Name:SAHA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 STINSON BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-2614
Mailing Address - Country:US
Mailing Address - Phone:612-672-2258
Mailing Address - Fax:
Practice Address - Street 1:10961 CLUB WEST PKWY
Practice Address - Street 2:
Practice Address - City:BLAINE
Practice Address - State:MN
Practice Address - Zip Code:55449-5866
Practice Address - Country:US
Practice Address - Phone:763-528-2987
Practice Address - Fax:763-528-2945
Is Sole Proprietor?:No
Enumeration Date:2009-07-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60280219208000000X
MN61350208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
H400333131OtherMEDICARE PTAN