Provider Demographics
NPI:1841425741
Name:ELMI, FEISAL MOHAMED
Entity Type:Individual
Prefix:
First Name:FEISAL
Middle Name:MOHAMED
Last Name:ELMI
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 18551
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-0551
Mailing Address - Country:US
Mailing Address - Phone:763-923-1138
Mailing Address - Fax:
Practice Address - Street 1:4241 3RD ST NE
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-2708
Practice Address - Country:US
Practice Address - Phone:763-923-1138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-20
Last Update Date:2009-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver