Provider Demographics
NPI:1437042587
Name:MOHIUDDIN, SUMAIYYA AIJAZ (MD)
Entity type:Individual
Prefix:DR
First Name:SUMAIYYA
Middle Name:AIJAZ
Last Name:MOHIUDDIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:502 2ND ST SW
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-3337
Mailing Address - Country:US
Mailing Address - Phone:320-251-2700
Mailing Address - Fax:320-231-8697
Practice Address - Street 1:502 2ND ST SW
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-3337
Practice Address - Country:US
Practice Address - Phone:320-251-2700
Practice Address - Fax:320-231-8697
Is Sole Proprietor?:No
Enumeration Date:2025-05-29
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program