Provider Demographics
NPI:1437912474
Name:MUHUMED, YASIN YAHYA
Entity Type:Individual
Prefix:
First Name:YASIN
Middle Name:YAHYA
Last Name:MUHUMED
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 1:13770 FRONTIER CT STE 105
Mailing Address - Street 2:
Mailing Address - City:BURNSVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55337-4810
Mailing Address - Country:US
Mailing Address - Phone:952-201-8429
Mailing Address - Fax:
Practice Address - Street 1:13770 FRONTIER CT STE 105
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55337-4810
Practice Address - Country:US
Practice Address - Phone:952-201-8429
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)