Provider Demographics
NPI:1427243898
Name:AHMED-SAUCEDO, REHANA LEILA (MD, PHD)
Entity type:Individual
Prefix:MS
First Name:REHANA
Middle Name:LEILA
Last Name:AHMED-SAUCEDO
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:14305 SOUTHCROSS DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55306
Mailing Address - Country:US
Mailing Address - Phone:651-340-1064
Mailing Address - Fax:651-330-0429
Practice Address - Street 1:14305 SOUTHCROSS DR
Practice Address - Street 2:SUITE 110
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306
Practice Address - Country:US
Practice Address - Phone:651-340-1064
Practice Address - Fax:651-330-0429
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MN51837207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program