Provider Demographics
NPI:1356216261
Name:ABDULLAH, ASIA KHAMILE
Entity type:Individual
Prefix:
First Name:ASIA
Middle Name:KHAMILE
Last Name:ABDULLAH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 4TH ST E STE 801
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-1687
Mailing Address - Country:US
Mailing Address - Phone:612-491-2099
Mailing Address - Fax:612-491-2099
Practice Address - Street 1:275 4TH ST E STE 801
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-1687
Practice Address - Country:US
Practice Address - Phone:612-491-2099
Practice Address - Fax:612-500-4906
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-09
Last Update Date:2025-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN25271210246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherGroup - Single Specialty