Maen Abou-Ghaida, MD
Individual provider Active NPI Sports Medicine (Orthopaedic Surgery) Physician · Crookston, MN
NPI 1174008288 · NPPES record last updated Apr 8, 2019
Key facts
- NPI
- 1174008288
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Medicine (Orthopaedic Surgery) Physician 207XX0005X
- License
- 63712 (MN)
- Practice address
- 323 S Minnesota St
Crookston, MN 56716-1601 - Phone
- (218) 281-9200
- Fax
- (218) 207-0489
- NPI assigned
- Sep 25, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63712 | MN | MD | Sports Medicine (Orthopaedic Surgery) Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Medicine (Orthopaedic Surgery) Physician | 207XX0005X | 63712 | MN | Yes |
Addresses
Primary practice location
323 S Minnesota St
Crookston, MN 56716-1601
Mailing address
323 S Minnesota St
Crookston, MN 56716-1601
Phone (218) 281-9200
Other providers in Crookston, MN
- Active Health Chiropractic
- Active Health Chiropractic PLLC
- Agassiz Optometry Associates PC
- Alluma, Inc.
- Altru Health System
All providers in Crookston, MN · Sports Medicine (Orthopaedic Surgery) Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.