Provider Demographics
NPI:1700844214
Name:NDYAJUNWOHA, SARAH ANN (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ANN
Last Name:NDYAJUNWOHA
Suffix:
Gender:F
Credentials:MD
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3033 EXCELSIOR BOULEVARD FAIRVIEW UPTOWN CLINIC
Mailing Address - Street 2:SUITE 275
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416
Mailing Address - Country:US
Mailing Address - Phone:612-827-4751
Mailing Address - Fax:612-827-7768
Practice Address - Street 1:3033 EXCELSIOR BOULEVARD FAIRVIEW UPTOWN CLINIC
Practice Address - Street 2:SUITE 275
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416
Practice Address - Country:US
Practice Address - Phone:612-827-4751
Practice Address - Fax:612-827-7768
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2012-03-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN46059207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN46059OtherSTATE LICENSE