Provider Demographics
NPI:1730059569
Name:TAMBAH, BRANKO SAAH
Entity type:Individual
Prefix:DR
First Name:BRANKO
Middle Name:SAAH
Last Name:TAMBAH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13280 ARDROE AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEMOUNT
Mailing Address - State:MN
Mailing Address - Zip Code:55068-4747
Mailing Address - Country:US
Mailing Address - Phone:651-757-6541
Mailing Address - Fax:651-842-7269
Practice Address - Street 1:7970 BROOKLYN BLVD STE 44
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55445-2722
Practice Address - Country:US
Practice Address - Phone:651-757-6541
Practice Address - Fax:651-842-7269
Is Sole Proprietor?:Yes
Enumeration Date:2025-11-06
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNBC717912171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171WH0202XOther Service ProvidersContractorHome ModificationsGroup - Multi-Specialty