Provider Demographics
NPI:1023469368
Name:ARALE, ABDI
Entity type:Individual
Prefix:
First Name:ABDI
Middle Name:
Last Name:ARALE
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:MOGADISHU, SOMALIA
Mailing Address - Street 2:
Mailing Address - City:MERKA
Mailing Address - State:LOWER SHABELLE
Mailing Address - Zip Code:MERC
Mailing Address - Country:SO
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1304 E LAKE ST STE 202
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1981
Practice Address - Country:US
Practice Address - Phone:612-888-0778
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-06-28
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN872023900024171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor