Individual
DR. KHALAFALLA BUSHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.B., B.S.
Contact information
Practice address
UNIVERSITY OF MINNESOTA PHYSICIANS, 516 DELAWARE STREET SE, PWB FIRST FLOOR, CLINIC 1A, MINNEAPOLIS, MN 55455
(612) 626-3004
Mailing address
UNIVERSITY OF MINNESOTA PHYSICIANS, 420 DELAWARE STREET SE, MMC 295, MINNEAPOLIS, MN 55455
(612) 624-6666
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
44165
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-00449
MEDICA CHOICE
MN
01
—
1029761
PREFERRED ONE
MN
01
—
141527
UCARE
MN
01
—
1518044
ARAZ
MN
01
—
397R2BU
BCBS
MN
01
—
HP34287
HEALTHPARTNERS
MN
Enumeration date
06/23/2006
Last updated
07/09/2007
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