Provider Demographics
NPI:1740448117
Name:TAREEN, MOHIBA K (MD)
Entity type:Individual
Prefix:DR
First Name:MOHIBA
Middle Name:K
Last Name:TAREEN
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Gender:F
Credentials:MD
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Mailing Address - Street 1:1835 COUNTY ROAD C W
Mailing Address - Street 2:250
Mailing Address - City:ROSEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55113-1352
Mailing Address - Country:US
Mailing Address - Phone:651-633-6883
Mailing Address - Fax:651-528-6276
Practice Address - Street 1:1835 COUNTY ROAD C W
Practice Address - Street 2:250
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-1352
Practice Address - Country:US
Practice Address - Phone:651-633-6883
Practice Address - Fax:651-528-6276
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-01
Last Update Date:2014-01-08
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Provider Licenses
StateLicense IDTaxonomies
MN54002207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN070000931Medicare PIN