Basic Information
Provider Information
NPI: 1881861235
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SADAK
FirstName: KARIM
MiddleName: THOMAS
NamePrefix: DR.
NameSuffix:  
Credential: MD, MSE
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 720 WASHINGTON AVE SE
Address2: SUITE 200
City: MINNEAPOLIS
State: MN
PostalCode: 554142904
CountryCode: US
TelephoneNumber: 6123656777
FaxNumber: 6123658001
Practice Location
Address1: 2512 S 7TH ST
Address2:  
City: MINNEAPOLIS
State: MN
PostalCode: 554541404
CountryCode: US
TelephoneNumber: 6123656777
FaxNumber: 6123658001
Other Information
ProviderEnumerationDate: 05/14/2008
LastUpdateDate: 08/18/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X55987MNN Allopathic & Osteopathic PhysiciansPediatrics 
2080P0207X55987MNY Allopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology

No ID Information.


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