Provider Demographics
NPI:1609977107
Name:IKRAMUDDIN, FARHA SAYEED (MD)
Entity type:Individual
Prefix:
First Name:FARHA
Middle Name:SAYEED
Last Name:IKRAMUDDIN
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:FARHA
Other - Middle Name:AW
Other - Last Name:SIDDIQUI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MBBS
Mailing Address - Street 1:PO BOX 860912
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55486-0912
Mailing Address - Country:US
Mailing Address - Phone:507-284-2511
Mailing Address - Fax:
Practice Address - Street 1:200 1ST ST SW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55905-0002
Practice Address - Country:US
Practice Address - Phone:507-284-2511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN46761208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN23-00416OtherSTATE MEDICA CHOICE
WI34802600Medicaid
MN702T3IKOtherBLUE CROSS BLUE SHIELD
MN23-00008OtherMEDICA-PRIMARY
MN986465200Medicaid
1043062OtherPREFERRED ONE
MT0149006Medicaid
IA0599266Medicaid
MN132634OtherU CARE
B686OtherCHAMPUS
2307518OtherARAZ
HP49460OtherHEALTH PARTNERS
MN702T3IKOtherBLUE CROSS BLUE SHIELD
MN132634OtherU CARE