Provider Demographics
NPI:1205629474
Name:MOHAMED, ABDIREHMAN
Entity type:Individual
Prefix:
First Name:ABDIREHMAN
Middle Name:
Last Name:MOHAMED
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 1:501 E 19TH ST APT 300
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-1808
Mailing Address - Country:US
Mailing Address - Phone:651-356-4293
Mailing Address - Fax:
Practice Address - Street 1:501 E 19TH ST APT 300
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-1808
Practice Address - Country:US
Practice Address - Phone:651-356-4293
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374U00000XNursing Service Related ProvidersHome Health AideGroup - Single Specialty
No171W00000XOther Service ProvidersContractor