Provider Demographics
NPI:1689612178
Name:MEHBOD, AMIR A (MD)
Entity Type:Individual
Prefix:
First Name:AMIR
Middle Name:A
Last Name:MEHBOD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:913 E 26TH ST
Mailing Address - Street 2:600
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-4515
Mailing Address - Country:US
Mailing Address - Phone:612-775-6200
Mailing Address - Fax:612-775-6222
Practice Address - Street 1:913 E 26TH ST
Practice Address - Street 2:600
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-4515
Practice Address - Country:US
Practice Address - Phone:612-775-6200
Practice Address - Fax:612-775-6222
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN41208174400000X, 207R00000X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN074289900Medicaid
MN074289900Medicaid
MN200001916Medicare ID - Type Unspecified