DR. BASHIR MOALLIN (NPI# 1144840463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144840463 |
| Entity Type | Individual |
| Full Name | DR. BASHIR MOALLIN |
| Credential | MD |
| Practice Address |
1555 Northway Dr Ste 200 Saint Cloud MN 56303-4913 |
| Practice Telephone | 3202403157 |
| Practice Fax Number | 3202403164 |
| Mailing Telephone | 3202403157 |
| Mailing Fax Number | 3202403164 |
| Enumeration Date | 2020-04-17 |
| Last Update Date | 2020-04-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Street Address |
1555 NORTHWAY DR STE 200 |
| City | SAINT CLOUD |
| State | MN |
| Zip Code | 56303-4913 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437106986 | Clarice Hanks Konshok | Family Medicine | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2006-05-30 |
| 1841802436 | Lauren Renae Martens | Pharmacist | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2020-08-17 |
| 1043832132 | Sadio Ahmed Mohamed | Student in an Organized Health Care Education/Training Program | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2020-05-12 |
| 1093336299 | Jennifer Ann Tarpenning | Student in an Organized Health Care Education/Training Program | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2020-04-29 |
| 1679193957 | Seth Nelson | Student in an Organized Health Care Education/Training Program | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2020-04-16 |
| 1346860632 | Svetlana Adusheva | Student in an Organized Health Care Education/Training Program | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2020-04-16 |
| 1851942007 | Elizabeth Louise Fiedler | Nurse Practitioner | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2019-09-27 |
| 1629630488 | Tyler John Stevens | Pharmacist | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2019-07-02 |
| 1417511270 | John Evenocheck | Student in an Organized Health Care Education/Training Program | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2019-04-26 |
| 1447813431 | Oluwatobi Olushoga Falade | Student in an Organized Health Care Education/Training Program | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2019-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841800463 | Daniel P Lahr | Radiologic Technologist | St Cloud Va Health Care System, 4801 Veterans Drive, St Cloud, MN 56303 | 2020-08-07 |
| 1730798398 | County of Stearns | Case Management | 705 Courthouse Square, St Cloud, MN 56303 | 2020-07-29 |
| 1669007126 | Aflah Transportation LLC | Non-emergency Medical Transport (VAN) | 3316 3rd Street North, Suite 129, Saint Cloud, MN 56303 | 2020-03-05 |
| 1609420942 | Stephanie Lynne Metzger | Nurse Practitioner | Centracare Clinic Riverc Ampus/nephrology, 1200 Sixth Ave North, St. Cloud, MN 56303 | 2019-07-25 |
| 1306406947 | Willow Tree Acupuncture LLC | Acupuncturist | 203 Cooper Ave N Suite 160, St. Cloud, MN 56303 | 2019-06-17 |
| 1821553520 | Alan Melvin Hoeper | Nurse Anesthetist, Certified Registered | Centracare Clinic Anesthesiology, 3701 12th St N, Suite 202, St. Cloud, MN 56303 | 2019-02-06 |
| 1437644465 | Brianna Larissa Justin | Speech-Language Pathologist | St. Cloud Hospital, 1406 6th Avenue N, St. Cloud, MN 56303 | 2018-06-22 |
| 1780186486 | Simplicity Health Pa | Family Medicine | 1511 Northway Dr Ste 103, Saint Cloud, MN 56303 | 2018-03-08 |
| 1639682925 | Dereje Beyene | Respiratory Therapist, Certified | 1406 15th Street North, Saint Cloud, MN 56303 | 2017-11-09 |
| 1740792761 | Lisa Ann Horner | Nurse Practitioner | 1555 Northway Drive #110, Centracare Complex Care Clinic, St Cloud, MN 56303 | 2017-10-31 |
| Find all providers in zip 56303 | ||||
| Taxonomy Code | 390200000X |
| Grouping | Student, Health Care |
| Classification | Student in an Organized Health Care Education/Training Program |
| An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |
| Notes: [1/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861019960 | Joshua Gangl | Student in an Organized Health Care Education/Training Program | 726 25th Ave N, Saint Cloud, MN 56303-3260 | 2020-07-06 |
| 1780210617 | Maryam Sadough Shahmirzadi | Student in an Organized Health Care Education/Training Program | 4340 Clearwater Rd Apt 116, Saint Cloud, MN 56301-9642 | 2020-03-23 |
| 1669005195 | Raven Forester | Student in an Organized Health Care Education/Training Program | 2404 Deer Creek Blvd, Saint Cloud, FL 34772-8206 | 2020-02-12 |
| 1699338228 | Erik Bartho | Student in an Organized Health Care Education/Training Program | 575 7th St S Apt 302, Saint Cloud, MN 56301-4345 | 2019-04-18 |
| 1881119022 | Leslie Joyce Gonzalez | Student in an Organized Health Care Education/Training Program | 2540 King Oak Cir, Saint Cloud, FL 34769-6643 | 2017-08-09 |
| 1114466588 | Jared Richard Sherman | Student in an Organized Health Care Education/Training Program | 1200 E Division St Apt 307, Apt 307, Saint Cloud, MN 56304-0933 | 2017-02-18 |
| 1679928956 | Mikala Rae Gaffke | Student in an Organized Health Care Education/Training Program | 1038 Manor Ct, Saint Cloud, MN 56303-4810 | 2016-04-25 |
| 1326450412 | Sara F Poginy | Student in an Organized Health Care Education/Training Program | 2006 11th Ave S, Saint Cloud, MN 56301-5643 | 2014-05-23 |
| 1295980183 | Cotto's Medical | Student in an Organized Health Care Education/Training Program | 405 Brown Chapel Rd, Saint Cloud, FL 34769-1935 | 2008-11-19 |
| 1043832132 | Sadio Ahmed Mohamed | Student in an Organized Health Care Education/Training Program | 1555 Northway Dr Ste 200, Saint Cloud, MN 56303-4913 | 2020-05-12 |
| Find all providers in SAINT CLOUD | ||||
| City | SAINT CLOUD |
| Zip Code | 56303 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.