Provider Demographics
NPI:1487018966
Name:GURE, AHMED
Entity Type:Individual
Prefix:
First Name:AHMED
Middle Name:
Last Name:GURE
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 1:7256 72ND LN N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55428-1631
Mailing Address - Country:US
Mailing Address - Phone:404-642-8914
Mailing Address - Fax:
Practice Address - Street 1:7256 72ND LN N
Practice Address - Street 2:
Practice Address - City:BROOKLYN PARK
Practice Address - State:MN
Practice Address - Zip Code:55428-1631
Practice Address - Country:US
Practice Address - Phone:404-642-8914
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN549 TNK347C00000X
MN569 KDX347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle