Provider Demographics
NPI:1477004554
Name:BILE, BASHIR ABDI
Entity Type:Individual
Prefix:
First Name:BASHIR
Middle Name:ABDI
Last Name:BILE
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 8269
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-0269
Mailing Address - Country:US
Mailing Address - Phone:612-701-3092
Mailing Address - Fax:
Practice Address - Street 1:2817 ANTHONY LN S STE 201
Practice Address - Street 2:
Practice Address - City:ST ANTHONY
Practice Address - State:MN
Practice Address - Zip Code:55418-2490
Practice Address - Country:US
Practice Address - Phone:612-701-3092
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN332B171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter