Individual
SOUAD N BROBBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
6350 W 143RD ST STE 200, SAVAGE, MN 55378-2890
(952) 428-1010
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11041
MN
363A00000X
Physician Assistant
PA04869
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8X6086
BCBS
TX
Enumeration date
06/15/2006
Last updated
12/22/2023
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