NPI 1023820024

Shuab Ahmedhadi Rage

Practitioner Driver Saint Cloud, MN

Practice location

Address: 1819 Highland Trl, Saint Cloud, MN 56301-7505
Phone: (901) 674-6645

Registered specialties

Driver Primary

Other Service Providers Taxonomy 172A00000X Licence K000-027-336-700 (MN)

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Registry record

NPI: 1023820024
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Jan 2025
Record last updated: 25 Jan 2025

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.