Provider Demographics
NPI:1134714686
Name:DUBED, ABDULLAHI MOHAMED (PHARMD)
Entity type:Individual
Prefix:
First Name:ABDULLAHI
Middle Name:MOHAMED
Last Name:DUBED
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1068 RAYMOND AVE APT 203
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55108-1535
Mailing Address - Country:US
Mailing Address - Phone:651-307-2658
Mailing Address - Fax:
Practice Address - Street 1:9165 CAHILL AVE
Practice Address - Street 2:
Practice Address - City:INVER GROVE HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55076-3542
Practice Address - Country:US
Practice Address - Phone:651-451-3975
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-06
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN124958183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist