Provider Demographics
NPI:1437475431
Name:ABDULLAHI, MOHAMED ABDULCADIR (MD)
Entity Type:Individual
Prefix:DR
First Name:MOHAMED
Middle Name:ABDULCADIR
Last Name:ABDULLAHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1527 E LAKE ST
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-6700
Mailing Address - Country:US
Mailing Address - Phone:612-345-7175
Mailing Address - Fax:
Practice Address - Street 1:1527 E LAKE ST
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-6700
Practice Address - Country:US
Practice Address - Phone:612-345-7175
Practice Address - Fax:612-778-9857
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN61874207RC0200X, 207RP1001X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease