Provider Demographics
NPI:1962440610
Name:AFIAT, SANAZ (MD)
Entity Type:Individual
Prefix:
First Name:SANAZ
Middle Name:
Last Name:AFIAT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SANAZ
Other - Middle Name:A
Other - Last Name:LOFTUS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3100 W 70TH ST
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4227
Mailing Address - Country:US
Mailing Address - Phone:952-848-8312
Mailing Address - Fax:952-848-8313
Practice Address - Street 1:3100 W 70TH ST
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4227
Practice Address - Country:US
Practice Address - Phone:952-848-8312
Practice Address - Fax:952-848-8313
Is Sole Proprietor?:No
Enumeration Date:2006-06-03
Last Update Date:2015-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46580207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN483997800Medicaid
MNCP4332OtherRAILROAD MEDICARE
MNCP4332OtherRAILROAD MEDICARE
MNI08682Medicare UPIN