Provider Demographics
NPI:1336427525
Name:RABIE, ELSAID MOHAMED (MB, BCH)
Entity Type:Individual
Prefix:
First Name:ELSAID
Middle Name:MOHAMED
Last Name:RABIE
Suffix:
Gender:M
Credentials:MB, BCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 CENTRACARE CIRCLE
Mailing Address - Street 2:SUITE 2400
Mailing Address - City:ST. CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-5000
Mailing Address - Country:US
Mailing Address - Phone:320-229-5099
Mailing Address - Fax:320-656-7115
Practice Address - Street 1:1900 CENTRACARE CIRCLE
Practice Address - Street 2:SUITE 2400
Practice Address - City:ST. CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-5000
Practice Address - Country:US
Practice Address - Phone:320-229-5099
Practice Address - Fax:320-229-5171
Is Sole Proprietor?:No
Enumeration Date:2011-07-22
Last Update Date:2024-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI100582207Q00000X
MN23646207Q00000X
MN56692207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine