Provider Demographics
NPI:1417710237
Name:AHMED, ABDIQAFAR AWIL
Entity Type:Individual
Prefix:
First Name:ABDIQAFAR
Middle Name:AWIL
Last Name:AHMED
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 1:2836 POMONA DR
Mailing Address - Street 2:
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54701-6845
Mailing Address - Country:US
Mailing Address - Phone:817-856-8141
Mailing Address - Fax:
Practice Address - Street 1:2836 POMONA DR
Practice Address - Street 2:
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54701-6845
Practice Address - Country:US
Practice Address - Phone:817-856-8141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver