Basic Information
| Provider Information | |||||||||
| NPI: | 1093096406 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ABU MINSHAR | ||||||||
| FirstName: | MARWAN | ||||||||
| MiddleName: | M.B. | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 6001 | ||||||||
| Address2: | |||||||||
| City: | FARGO | ||||||||
| State: | ND | ||||||||
| PostalCode: | 581086001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7013648000 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 3000 32ND AVE S | ||||||||
| Address2: | |||||||||
| City: | FARGO | ||||||||
| State: | ND | ||||||||
| PostalCode: | 581036132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7013648000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2011 | ||||||||
| LastUpdateDate: | 10/17/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RN0300X | 4301104727 | MI | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207R00000X | BP10040884 | TX | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | 14030 | ND | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | 207RN0300X | 60976 | MN | N | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.