Individual
SHAZ IQBAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9145 SPRINGBROOK DR NW STE 200, COON RAPIDS, MN 55433-5886
(612) 871-1145
(612) 870-5491
Mailing address
6201 GREENLEIGH AVE, MIDDLE RIVER, MD 21220-2004
(410) 933-6421
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
D89424
MD
207RG0100X
Gastroenterology Physician
Primary
69024
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D89424
LICENSE
MD
Enumeration date
04/05/2015
Last updated
09/03/2021
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