Individual provider · NPI-1

Omar F Abou Ezzeddine, MD

Internal Medicine, Advanced Heart Failure and Transplant Cardiology · Rochester, MN

NPI number1740480391
StatusActive
Last updated in NPPESAug 11, 2020

Details

NPI
1740480391
Entity type
Individual (NPI-1)
Name
Omar F Abou Ezzeddine
Credential
MD
Sex
Male
Sole proprietor
No
Enumeration date
Jul 23, 2007
Certification date
Aug 11, 2020
Last updated
Aug 11, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207RA0001X Internal Medicine, Advanced Heart Failure and Transplant Cardiology50744MNYes
207R00000X Internal Medicine50744MN
207RC0000X Internal Medicine, Cardiovascular Disease50744MN

Practice location

200 1st St Sw
Rochester, MN 55905-0001

Phone 507-284-2511

Mailing address

200 1st St Sw
Rochester, MN 55905-0001

Phone 507-284-2511

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