Individual
MASHA HEMMATI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2810 NICOLLET AVE, MINNEAPOLIS, MN 55408-4708
(612) 873-8060
Mailing address
215 10TH AVE S, MINNEAPOLIS, MN 55415-1268
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
46558
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
607669600
—
MN
Enumeration date
06/10/2006
Last updated
09/24/2012
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