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Individual

DR. AYESHA EBRAHIM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1185 TOWN CENTRE DR, SUITE 220, EAGAN, MN 55123-1187
(651) 379-1600
(651) 379-1650
Mailing address
1185 TOWN CENTRE DR, SUITE 220, EAGAN, MN 55123-1187
(651) 379-1600
(651) 379-1650

Taxonomy

Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
44536
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
113138
UCARE
MN
01
2418104
AMERICA'S PPO
MN
01
33-00259
MEDICA
MN
01
615K3EB
BLUE CROSS BLUE SHIELD
MN
05
80483500
MN
01
HP51736
HEALTHPARTNERS
MN
01
NA9521031165
PREFERRED ONE
MN
Enumeration date
05/23/2006
Last updated
02/21/2012
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