Provider Demographics
NPI:1508316068
Name:ABDI, ABDINASAR
Entity Type:Individual
Prefix:
First Name:ABDINASAR
Middle Name:
Last Name:ABDI
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 1:5906 HICKMAN RD APT 6
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50322-6039
Mailing Address - Country:US
Mailing Address - Phone:612-229-6619
Mailing Address - Fax:
Practice Address - Street 1:1535 E 13TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-2431
Practice Address - Country:US
Practice Address - Phone:612-229-6619
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-09
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WV0202XOther Service ProvidersContractorVehicle Modifications