Organization
MECCA MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
IDRISS IBRAHIM NP (MEDICAL DIRECTOR)
(507) 530-6028
Entity
Organization
Contact information
Practice address
309 E COLLEGE DR, MARSHALL, MN 56258-2379
(507) 530-6028
Mailing address
1120 BIRCH ST APT 2, MARSHALL, MN 56258-1550
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
09/25/2019
Last updated
02/20/2020
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