Provider Demographics
NPI:1205447505
Name:MAXAMED, ABDULLAHI
Entity type:Individual
Prefix:
First Name:ABDULLAHI
Middle Name:
Last Name:MAXAMED
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 1:661 HIAWATHA AVE
Mailing Address - Street 2:
Mailing Address - City:VADNAIS HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55127-5116
Mailing Address - Country:US
Mailing Address - Phone:612-814-2911
Mailing Address - Fax:
Practice Address - Street 1:661 HIAWATHA AVE
Practice Address - Street 2:
Practice Address - City:VADNAIS HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55127-5116
Practice Address - Country:US
Practice Address - Phone:612-814-2911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372500000XNursing Service Related ProvidersChore Provider