Basic Information
Provider Information
NPI: 1750338232
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SIRR
FirstName: STEVEN
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1221 NICOLLET AVE
Address2: SUITE 600
City: MINNEAPOLIS
State: MN
PostalCode: 554032420
CountryCode: US
TelephoneNumber: 6125732232
FaxNumber: 6125732274
Practice Location
Address1: 1221 NICOLLET AVE
Address2: SUITE 600
City: MINNEAPOLIS
State: MN
PostalCode: 554032420
CountryCode: US
TelephoneNumber: 6125732232
FaxNumber: 6125732274
Other Information
ProviderEnumerationDate: 05/28/2006
LastUpdateDate: 07/02/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X25907MNY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

ID Information
IDTypeStateIssuerDescription
2301001MNAMERICA'S PPOOTHER
HP1440801MNHEALTHPARTNERSOTHER
052447005IA MEDICAID
10858201MNUCAREOTHER
30008187301MNRAILROAD MEDICARE MNOTHER
4F542SI01MNBLUE CROSSOTHER
20036270005MN MEDICAID
30002904201WIRAILROAD MEDICARE WIOTHER
3069280005WI MEDICAID
44OT6SI01MNBLUE CROSSOTHER
101677301MNPREFERRED ONEOTHER


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