Provider Demographics
NPI:1093197758
Name:WARSAME, ABDULCADIR M
Entity Type:Individual
Prefix:
First Name:ABDULCADIR
Middle Name:M
Last Name:WARSAME
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:PO BOX 702
Mailing Address - Street 2:
Mailing Address - City:OWATONNA
Mailing Address - State:MN
Mailing Address - Zip Code:55060-0702
Mailing Address - Country:US
Mailing Address - Phone:507-213-1248
Mailing Address - Fax:
Practice Address - Street 1:221 MINERAL SPRINGS RD
Practice Address - Street 2:
Practice Address - City:OWATONNA
Practice Address - State:MN
Practice Address - Zip Code:55060-2197
Practice Address - Country:US
Practice Address - Phone:507-213-1248
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-18
Last Update Date:2015-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN381124343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN381124OtherSPECIAL TRANSPORTATION SERVICES