Individual
KENAN TAYSSIR RADDAWI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 E UNIVERSITY PKWY, DEPT OF MEDICINE, BALTIMORE, MD 21218-2829
(410) 554-2284
(410) 554-2184
Mailing address
1925 WOODWINDS DR DEPT OF, WOODBURY, MN 55125-4445
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
71699
MN
208M00000X
Hospitalist Physician
Primary
71699
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/20/2019
Last updated
10/18/2022
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