Individual
SHABANA FEROZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7840 VINEWOOD LN N, MAPLE GROVE, MN 55369-7185
(763) 236-0200
(763) 420-5531
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(989) 742-4583
(989) 742-4298
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
106469
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0F06016
MEDICARE BILL PAY TO
MI
05
—
4162375
—
MI
05
—
4162455
—
MI
05
—
4162464
—
MI
05
—
4884782
—
MI
Enumeration date
05/19/2006
Last updated
11/30/2012
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