Provider Demographics
NPI:1053640706
Name:IGAL, ABDIRIZAQ ABSHIR
Entity Type:Individual
Prefix:
First Name:ABDIRIZAQ
Middle Name:ABSHIR
Last Name:IGAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 E FRANKLIN AVE APT 106
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-2158
Mailing Address - Country:US
Mailing Address - Phone:612-483-0218
Mailing Address - Fax:
Practice Address - Street 1:1518 E FRANKLIN AVE APT 106
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-2158
Practice Address - Country:US
Practice Address - Phone:612-483-0218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-09
Last Update Date:2009-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)