Provider Demographics
NPI:1861588121
Name:SHAMSI, ALIYA A (MD)
Entity type:Individual
Prefix:
First Name:ALIYA
Middle Name:A
Last Name:SHAMSI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:3033 EXCELSIOR BLVD
Mailing Address - Street 2:SUITE 275
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55416-4688
Mailing Address - Country:US
Mailing Address - Phone:612-827-4751
Mailing Address - Fax:612-827-7768
Practice Address - Street 1:3033 EXCELSIOR BLVD
Practice Address - Street 2:SUITE 275
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55416-4688
Practice Address - Country:US
Practice Address - Phone:612-827-4751
Practice Address - Fax:612-827-7768
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2012-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MN45854207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H48479Medicare UPIN