Provider Demographics
NPI:1962604892
Name:HAMIEH, TAREK S (MD)
Entity type:Individual
Prefix:
First Name:TAREK
Middle Name:S
Last Name:HAMIEH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 CAMPUS DR STE 10
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-2669
Mailing Address - Country:US
Mailing Address - Phone:763-398-4400
Mailing Address - Fax:651-254-1553
Practice Address - Street 1:3366 OAKDALE AVE N STE 401
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2986
Practice Address - Country:US
Practice Address - Phone:763-520-2940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-04
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35089729207R00000X
MN51130207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine