Provider Demographics
NPI:1912054214
Name:SURI, MUHAMMAD FAREED KHAN (MBBS)
Entity Type:Individual
Prefix:DR
First Name:MUHAMMAD FAREED
Middle Name:KHAN
Last Name:SURI
Suffix:
Gender:M
Credentials:MBBS
Other - Prefix:DR
Other - First Name:MUHAMMAD FAREED
Other - Middle Name:KHAN
Other - Last Name:SURI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MBBS
Mailing Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Mailing Address - Street 2:420 DELAWARE ST SE, MMC 295
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455
Mailing Address - Country:US
Mailing Address - Phone:612-626-3004
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF MINNESOTA PHYSICIANS
Practice Address - Street 2:516 DELAWARE ST SE, CLINIC 1A
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55455
Practice Address - Country:US
Practice Address - Phone:612-626-3004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN492432084N0400X
NJ25MA080042002084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology