Individual
DR. BASHIR MOALLIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MBBS
Contact information
Practice address
1555 NORTHWAY DR STE 200, SAINT CLOUD, MN 56303-4913
(320) 240-3157
(320) 240-3164
Mailing address
3405 3RD ST N, SAINT CLOUD, MN 56303-4015
(320) 774-1041
(320) 774-1049
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
70813
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/17/2020
Last updated
12/28/2024
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