Individual
DR. IBKHAN ANSINE
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 HIGHWAY 65 S, MORA, MN 55051-1899
(320) 225-3335
(320) 225-3345
Mailing address
301 HIGHWAY 65 S, MORA, MN 55051-1899
(320) 225-3335
(320) 225-3345
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
41439
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12D50AN
BC PROVIDER NUMBER
MN
Enumeration date
03/28/2006
Last updated
07/09/2007
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