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Organization

SHIFA MENTAL HEALTH SERVICES PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SALIMA NAQVI M.D (ORGANIZER)
(612) 386-5020
Entity
Organization

Contact information

Practice address
2781 PILOT KNOB RD, EAGAN, MN 55121-1119
(651) 289-7300
(651) 289-7301
Mailing address
3044 170TH ST SW, PRIOR LAKE, MN 55372-2334

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
50545
MN
2084P0802X
Addiction Psychiatry Physician
50545
MN
261QM0850X
Adult Mental Health Clinic/Center

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1912041278
MN
01
H100102182
MDCR PTAN GROUP
MN
01
H400102209
MEDICARE PTAN INDIVIDUAL
MN
Enumeration date
09/10/2013
Last updated
01/06/2014
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