Maen Abou-Ghaida, MD

Primary specialty

Sports Medicine (Orthopaedic Surgery) PhysicianTaxonomy code 207XX0005X

License

63712 Issued in MN

Practice address

323 S Minnesota St
Crookston, MN 56716-1601

Phone

(218) 281-9200

Fax

(218) 207-0489

NPI assigned

Sep 25, 2018

Last updated

Apr 8, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1537833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1174008288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "323 S MINNESOTA ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567161601",
            "telephone_number": "218-281-9200",
            "fax_number": "218-207-0489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "323 S MINNESOTA ST",
            "city": "CROOKSTON",
            "state": "MN",
            "postal_code": "567161601",
            "telephone_number": "218-281-9200",
            "fax_number": "218-207-0489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOU-GHAIDA",
        "first_name": "MAEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-25",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207XX0005X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": "MN",
            "license": "63712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Active Health Chiropractic (Active Health Family Chiropractic)
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• Alluma, Inc.
• Altru Health System (Altru Health System Renal Dialysis Crookston)

• Sports Medicine (Orthopaedic Surgery) Physician in Crookston, MN
• Providers in Crookston, MN by specialty
• Sports Medicine (Orthopaedic Surgery) Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.