Provider Demographics
NPI:1043054489
Name:DUQOW, SHARMAKE
Entity type:Individual
Prefix:
First Name:SHARMAKE
Middle Name:
Last Name:DUQOW
Suffix:
Gender:U
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8609 LYNDALE AVE S STE 201A
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55420-2754
Mailing Address - Country:US
Mailing Address - Phone:612-517-4331
Mailing Address - Fax:612-439-8005
Practice Address - Street 1:8609 LYNDALE AVE S STE 201A
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55420-2754
Practice Address - Country:US
Practice Address - Phone:612-517-4331
Practice Address - Fax:612-439-8005
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-20
Last Update Date:2024-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)