Faruk Said Abuzzahab Sr., M.D., PHD
Individual provider Active NPI Psychiatry Physician · St Louis Park, MN
NPI 1396714705 · NPPES record last updated May 27, 2008
Key facts
- NPI
- 1396714705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- 17068 (MN)
- Practice address
- 3601 Park Center Blvd
Suite 207
St Louis Park, MN 55416-2531 - Phone
- (952) 926-3364
- Fax
- (952) 926-3369
- NPI assigned
- Mar 16, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
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, Doctor of Philosophy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Clinical Psychopharmacology Consultants, PA | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 17068 | MN | Yes |
Addresses
Primary practice location
3601 Park Center Blvd
Suite 207
St Louis Park, MN 55416-2531
Mailing address
3601 Park Center Blvd
Suite 207
St Louis Park, MN 55416-2531
Phone (952) 926-3364
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 260000176 | Medicaid | MN | |
| 938573800 | Medicaid | MN |
Other providers in St Louis Park, MN
- Elizabeth Abell
- David J Abelson
- Maggie Abraham
- Ansin Abrahim
- Raed D Abughazaleh
- Sidoline Achemenkong
- Acqua Chiropractic, LLC
- Act Psychological Services, PLLC
- Shannon Jeanette Acuna
- George Adam
All providers in St Louis Park, MN · Psychiatry 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 May 27, 2008. 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.