Provider Demographics
NPI:1831651249
Name:ADEN, ABDULLAHI MOHAMED
Entity Type:Individual
Prefix:
First Name:ABDULLAHI
Middle Name:MOHAMED
Last Name:ADEN
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 1:1435 5TH AVE
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50314-3216
Mailing Address - Country:US
Mailing Address - Phone:515-779-6923
Mailing Address - Fax:
Practice Address - Street 1:1435 5TH AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3216
Practice Address - Country:US
Practice Address - Phone:515-779-6923
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-03
Last Update Date:2023-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA920AL1141171W00000X, 172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver
No171W00000XOther Service ProvidersContractor