Individual
MR. ABASS AHMED BASHA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10000 ZANE AVE N, BROOKLYN PARK, MN 55443-1400
(763) 528-6999
Mailing address
9929 BUTTERNUT CIR N, BROOKLYN PARK, MN 55443-1845
(612) 518-0664
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2120
MN
Other
Enumeration date
07/11/2014
Last updated
07/11/2014
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