Moghaddam, Maryam Lee
Moghaddam, Maryam Lee is an sole proprietor health care provider with primary practice located at 14500 99Th Ave N , Maple Grove MN 55369-4730. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, which is considered as her primary health care specialty. Moghaddam, Maryam Lee can be contacted via phone (763) 898-1000.Contact Information
Primary practice address
14500 99Th Ave N
Maple Grove MN 55369-4730
Phone: (763) 898-1000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | 31579 | Minnesota |
Profile Details
| NPI number | 1811958424 |
|---|---|
| LBN Legal business name | Moghaddam, Maryam Lee |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 31st, 2006 |
| Last updated | Feb 7th, 2013 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811958424 | NPPES |
| Minnesota | MEDICAID | 309397200 |
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