Provider Demographics
NPI:1649246513
Name:AFGARSHE, MOHAMUD D (MD)
Entity type:Individual
Prefix:
First Name:MOHAMUD
Middle Name:D
Last Name:AFGARSHE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:451 DUNLAP ST N
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-4619
Mailing Address - Country:US
Mailing Address - Phone:651-999-4700
Mailing Address - Fax:651-999-4781
Practice Address - Street 1:451 DUNLAP ST N
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-4619
Practice Address - Country:US
Practice Address - Phone:651-999-4700
Practice Address - Fax:651-999-4781
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN45178207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN500035100Medicaid
MN500035100Medicaid
H68681Medicare UPIN