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Individual

REEDADA S IDRISS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
24 HOSPITAL AVE, DANBURY, CT 06810-6099
(203) 739-7000
Mailing address
5120 DUVALL PL NW, ROCHESTER, MN 55901-3821
(507) 287-1831

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
047400
CT
207P00000X
Emergency Medicine Physician
49753
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
297122100
MN
05
35174100
WI
05
ENROLLED
IA
Enumeration date
05/07/2007
Last updated
06/02/2009
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