ADAM SOUHAIL ALDAHAN (NPI# 1609304617) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609304617 |
| Entity Type | Individual |
| Full Name | ADAM SOUHAIL ALDAHAN |
| Credential | MD |
| Practice Address |
3800 Park Nicollet Blvd St Louis Park MN 55416 |
| Mailing Address |
3800 Park Nicollet Blvd St Louis Park MN 55416-2527 |
| Practice Telephone | 9529933286 |
| Mailing Telephone | 9529933286 |
| Enumeration Date | 2017-06-03 |
| Last Update Date | 2019-10-21 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 65072 | MN | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | FL | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 420 Delaware St Se, Minneapolis, MN 55455 | 6126249964 | |
| 1021 Bandana Blvd E Ste 100, Saint Paul, MN 551085109 | 6512419700 | 6512419678 |
| 3800 Park Nicollet Blvd, St Louis Park, MN 55416 | 9529933286 |
| Street Address |
3800 PARK NICOLLET BLVD |
| City | ST LOUIS PARK |
| State | MN |
| Zip Code | 55416 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861497745 | Mary C Fields | Psychiatry & Neurology | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2005-06-16 |
| 1316552383 | Emily Elizabeth Morimoto | Psychologist | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2020-09-15 |
| 1245862846 | Caara Hirsch Leintz | Physician Assistant | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2020-02-11 |
| 1477102770 | Kyja Foster | Counselor | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-09-09 |
| 1750938411 | Abigale Jayne Harris | Social Worker | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-08-19 |
| 1912552076 | Michael Patrick Miller | Dietitian, Registered | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-08-06 |
| 1083277743 | Jessica B Arndt | Social Worker | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2019-04-18 |
| 1043785157 | Jerry L Juhl | Physical Therapist | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2018-10-05 |
| 1437624558 | Chandler Elise Domian Ommen | Occupational Therapist | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2018-10-04 |
| 1861977472 | Sarah Ruth Tupper | Nurse Practitioner | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2018-09-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639711492 | Ismahan Abdirahman Mohamed | Psychologist | 4236 Parkglen Rd, St Louis Park, MN 55416 | 2019-10-14 |
| 1598307860 | Ayman Abulaziz Mohamed | Counselor | 4326 Park Glen Rd, St Louis Park, MN 55416 | 2019-10-08 |
| 1831758929 | Ally Group Homes LLC | Assisted Living Facility | 2944 Princeton Ave South, Saint Louis Park, MN 55416 | 2019-06-11 |
| 1609371525 | Heather Margaret Flatgard | Chiropractor | 5407 Excelsior Blvd Ste D, St Louis Park, MN 55416 | 2018-03-25 |
| 1942702394 | Polaris Pharmacy Services of Minnesota, LLC | Pharmacy | 4220 Park Glen Road, St. Louis Park, MN 55416 | 2018-03-01 |
| 1316469760 | Evert Ray Boyd | Psychologist | 3200 Highway 100 S., Groves Academy, St Louis Park, MN 55416 | 2017-07-07 |
| 1861941684 | Amanda Marie Tapper | Marriage & Family Therapist | 5407 Excelsior Blvd, Suite B, St Louis Park, MN 55416 | 2016-09-22 |
| 1326410416 | Clear Health Chiropractic LLC | Chiropractor | 5614 W 36th St, St. Louis Park, MN 55416 | 2015-10-28 |
| 1568897833 | Kay Elizabeth Lichtenberger | Physical Therapist | 4415 W 36.5 St, St. Louis Park, MN 55416 | 2013-09-05 |
| 1710221510 | Aaron Christopher Oppelt | Counselor | 1665 Utica Ave South - Suite 100, Saint Louis Park, MN 55416 | 2012-11-16 |
| Find all providers in zip 55416 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144207952 | Allison L Schini | Dermatology | Park Nicollet Clinic - Slp, 3800 Park Nicollet Blvd Admin 7n, St Louis Park, MN 55416 | 2005-12-22 |
| 1417944349 | Scott M Ross | Dermatology | 4201 Excelsior Blvd, St Louis Park, MN 55416 | 2005-10-05 |
| 1619364494 | Jaime Loso | Dermatology | 3800 Park Nicollet Blvd, St Louis Park, MN 55416 | 2015-04-20 |
| 1225443419 | Jennifer Day | Dermatology | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2014-06-25 |
| 1699193714 | Kathryn Therese Shahwan | Dermatology | 3850 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2014-04-05 |
| 1922442599 | Albert Gutierrez Jr. | Dermatology | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2013-04-25 |
| 1679837637 | Desiree Alaina Mohandas | Dermatology | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2012-06-25 |
| 1104143437 | Anne B Neeley | Dermatology | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2010-04-27 |
| 1215199963 | Larisa Sotinsky Speetzen | Dermatology | 3800 Park Nicollet Blvd, St Louis Park, MN 55416-2527 | 2008-06-25 |
| 1780876987 | Katherine A Biebl Duckworth | Dermatology | 3800 Park Nicollet Blvd, Department of Dermatology, St Louis Park, MN 55416-2527 | 2007-08-13 |
| Find all providers in ST LOUIS PARK | ||||
| City | ST LOUIS PARK |
| Zip Code | 55416 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.