Organization
SEDRA MEDICAL CLINIC PLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAZEM SEDRA MD (PRESIDENT)
(218) 683-5137
Entity
Organization
Contact information
Practice address
213 LABREE AVE N, SUITE #207, THIEF RIVER FALLS, MN 56701-2022
(218) 683-5137
(218) 683-5413
Mailing address
213 LABREE AVE N, SUITE #207, THIEF RIVER FALLS, MN 56701-2022
(218) 683-5137
(218) 683-5413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
47271
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1669408753
INDIVIDUAL NPI
MN
05
—
590610500
—
MN
Enumeration date
01/09/2013
Last updated
01/09/2013
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