Individual
MAHSA MOGHADDAM SMOOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBBS
Contact information
Practice address
1650 4TH ST SE, ROCHESTER, MN 55904-4717
(507) 529-6600
Mailing address
1650 4TH ST SE, ROCHESTER, MN 55904-4717
(507) 529-6600
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
49671
MN
208600000X
Surgery Physician
49671
MN
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
49671
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
307488000
—
MN
01
—
49671
MEDICAL LICENSE
MN
Enumeration date
02/08/2007
Last updated
08/01/2023
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