DR. FEREYDOON MAHJOURI (NPI# 1710095419) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710095419 |
| Entity Type | Individual |
| Full Name | DR. FEREYDOON MAHJOURI |
| Credential | M.D. |
| Practice Address |
500 Osborne Rd Ne Suite 130 Fridley MN 55432-2765 |
| Practice Telephone | 7637802770 |
| Practice Fax Number | 7637802812 |
| Mailing Telephone | 7637802770 |
| Mailing Fax Number | 7637802812 |
| Enumeration Date | 2006-08-25 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 23415 | MN | Other Service Providers |
| Street Address |
500 OSBORNE RD NE SUITE 130 |
| City | FRIDLEY |
| State | MN |
| Zip Code | 55432-2765 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407851694 | Crystal M Dexter | Family Medicine | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2774 | 2005-06-15 |
| 1083152367 | Angela Bennett | Pediatrics | 500 Osborne Rd Ne, Suite 215, Fridley, MN 55432-2765 | 2017-02-07 |
| 1902263866 | Jennifer Alma Wilson | Registered Nurse | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2774 | 2016-01-24 |
| 1689067860 | Mona Abdel-bary | Family Medicine | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2765 | 2015-03-11 |
| 1073935219 | Jill Marrone | Dietitian, Registered | 500 Osborne Rd Ne, Suite 200, Fridley, MN 55432-2765 | 2014-01-07 |
| 1164844304 | Michelle Mezera | Dietitian, Registered | 500 Osborne Rd Ne, Suite 200, Fridley, MN 55432-2765 | 2014-01-07 |
| 1720315567 | Cities Lung Clinic Pa | Internal Medicine | 500 Osborne Rd Ne, Suite 360, Fridley, MN 55432-2783 | 2009-11-16 |
| 1932341252 | Lucie Larson | Obstetrics & Gynecology | 500 Osborne Rd Ne, Suite 255, Fridley, MN 55432-2765 | 2009-04-01 |
| 1437399250 | Advanced Cosmetic & Plastic Surgery | Specialist | 500 Osborne Rd Ne, Suite 130, Fridley, MN 55432-2765 | 2009-03-06 |
| 1255588299 | Metropolitan Cardiology Consultants | Specialist | 500 Osborne Rd Ne, Suite 120, Fridley, MN 55432-2765 | 2008-08-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336791177 | Adelyn Ruth Kopp | Occupational Therapist | 500 Osborne Rd Ne Suite 365, Fridley, MN 55432 | 2019-07-11 |
| 1831665603 | White Smiles Family Dentistry Pllc | Dentist | 1611 County Hwy 10, Minneapolis, MN 55432 | 2018-10-19 |
| 1518402213 | Peaceful Adult Day Center LLC. | Home Health | 6267 University Ave Ne, Fridley, MN 55432 | 2017-01-04 |
| 1205383742 | Farhiya Mahamud Gelle I | Durable Medical Equipment & Medical Supplies | 6329 5th Street Ne Apt 8, Fridley, MN 55432 | 2016-09-01 |
| 1093163164 | Christiane Schwecke | Specialist/Technologist | 8290 University Ave N, Fridley, MN 55432 | 2016-05-31 |
| 1336551563 | Amy White Mountain | Massage Therapist | 1611 County Hwy 10 Ne, Spring Lake Park, MN 55432 | 2014-05-22 |
| 1942629795 | Shane O'neil | Dermatology | 500 Osborne Rd Ne Ste 330, Fridley, MN 55432 | 2014-04-09 |
| 1952648180 | John Franklyn Marshall | Family Medicine | 480 Osborne Road Ne, Suite 100, Fridley, MN 55432 | 2013-01-08 |
| 1558610519 | Novacare Outpatient Rehabilitation East Inc | Clinic/Center | 480 Osborne Road, Number 280, Fridley, MN 55432 | 2012-09-06 |
| 1336423391 | Christian Restoration Services | Counselor | 7157 Commerce Circle W, Fridley, MN 55432 | 2011-10-07 |
| Find all providers in zip 55432 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629454319 | Ashley Culhane | Specialist | 8290 University Ave Ne Ste 200, Fridley, MN 55432-1876 | 2015-08-04 |
| 1437399250 | Advanced Cosmetic & Plastic Surgery | Specialist | 500 Osborne Rd Ne, Suite 130, Fridley, MN 55432-2765 | 2009-03-06 |
| 1255588299 | Metropolitan Cardiology Consultants | Specialist | 500 Osborne Rd Ne, Suite 120, Fridley, MN 55432-2765 | 2008-08-21 |
| 1396918207 | Vidu Bala Mokkala | Specialist | 550 Osborne Rd Ne, Fridley, MN 55432-2718 | 2008-04-11 |
| 1801080353 | Aesthetic-reconstructive Plastic Surgery, Ltd | Specialist | 500 Osborne Rd Ne, Unity Professional Bldg Suite 350, Fridley, MN 55432-2765 | 2007-08-28 |
| 1023107224 | Thomas J Diem | Specialist | 500 Osborne Rd Ne, Unity Professional Bldg Suite 350, Fridley, MN 55432-2765 | 2006-10-12 |
| 1083718274 | Julius Eliezer Edlavitch | Specialist | 500 Osborne Rd Ne, 310, Fridley, MN 55432-2765 | 2006-09-11 |
| 1396852091 | Jill M Simons | Specialist | 500 Osborne Rd Ne, 310, Fridley, MN 55432-2765 | 2006-08-25 |
| 1326156050 | Lisa Claire Freitag | Specialist | 500 Osborne Rd Ne, 310, Fridley, MN 55432-2765 | 2006-08-25 |
| 1942317888 | John Robert Hollerud | Specialist | 500 Osborne Rd Ne, 310, Fridley, MN 55432-2765 | 2006-08-24 |
| Find all providers in FRIDLEY | ||||
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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.