| Medina Medical Clinic & Urgent Care | |
|
1516 E Lake St Ste 1512 Minneapolis MN 55407-1997 | |
| (651) 361-0029 | |
| Not Available |
| Full Name | Medina Medical Clinic & Urgent Care |
|---|---|
| Speciality | Family Medicine |
| Location | 1516 E Lake St Ste 1512, Minneapolis, Minnesota |
| Authorized Official Name and Position | Ubah Ahmed Keynan (PROVIDER/MEDICAL DIRECTOR) |
| Authorized Official Contact | 6122290285 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Medina Medical Clinic & Urgent Care 1516 E Lake Street Suit # 1512 Minneapolis MN 55407-1997 Ph: (612) 229-0285 | Medina Medical Clinic & Urgent Care 1516 E Lake St Ste 1512 Minneapolis MN 55407-1997 Ph: (651) 361-0029 |
| NPI Number | 1457957383 |
|---|---|
| Provider Enumeration Date | 12/07/2020 |
| Last Update Date | 04/25/2024 |
| Medicare PECOS PAC ID | 5294142550 |
|---|---|
| Medicare Enrollment ID | O20210402000148 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457957383 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Zahra A Roble |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1437506417 PECOS PAC ID: 0244527760 Enrollment ID: I20160928000188 |
| Provider Name | Sadiya M Firin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1922641216 PECOS PAC ID: 0143638924 Enrollment ID: I20210415001041 |
| Provider Name | Michael Am Nyantaroka |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1942857818 PECOS PAC ID: 8224464748 Enrollment ID: I20231024002925 |
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