Provider Demographics
NPI:1497431241
Name:ABDIRAHMAN, JAMAL IBRAHIM
Entity Type:Individual
Prefix:
First Name:JAMAL
Middle Name:IBRAHIM
Last Name:ABDIRAHMAN
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 1:7529 YORK AVE S
Mailing Address - Street 2:
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-4708
Mailing Address - Country:US
Mailing Address - Phone:612-464-5898
Mailing Address - Fax:612-254-2582
Practice Address - Street 1:7529 YORK AVE S
Practice Address - Street 2:
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-4708
Practice Address - Country:US
Practice Address - Phone:612-464-5898
Practice Address - Fax:612-254-2582
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-26
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care