NPI 1003236704

Laura Woodbeck Moustafa

Practitioner Pediatrics Physician Maple Grove, MN

Practice location

Address: 12720 Bass Lake Rd, Maple Grove, MN 55369-6307
Phone: (763) 559-2861

Registered specialties (2)

Pediatrics Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208000000X Licence 61732 (MN)

Other Pediatrics providers in Minnesota →

Student in an Organized Health Care Education/Training Program

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1003236704
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Apr 2014
Record last updated: 11 May 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.