Provider Demographics
NPI:1770398406
Name:ABDULLE, MOHAMED Y
Entity type:Individual
Prefix:MR
First Name:MOHAMED
Middle Name:Y
Last Name:ABDULLE
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 1:4995 LARCH LN N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55442-2051
Mailing Address - Country:US
Mailing Address - Phone:763-340-5690
Mailing Address - Fax:
Practice Address - Street 1:4995 LARCH LN N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55442-2051
Practice Address - Country:US
Practice Address - Phone:763-340-5690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator