Individual
KATAYOON BARADARAN EBRAHIMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1717 UNIVERSITY DR S, FARGO, ND 58103-4939
(701) 461-5100
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
(701) 234-2000
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
18004
ND
207W00000X
Ophthalmology Physician
2016-01788
NC
207W00000X
Ophthalmology Physician
MD463064
PA
Other
Enumeration date
01/04/2016
Last updated
06/13/2022
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