Provider Demographics
NPI:1801592092
Name:ABDIRAHMAN, AHMED M
Entity type:Individual
Prefix:
First Name:AHMED
Middle Name:M
Last Name:ABDIRAHMAN
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 1:1928 PORTLAND AVE APT S411
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-3469
Mailing Address - Country:US
Mailing Address - Phone:612-227-6595
Mailing Address - Fax:
Practice Address - Street 1:1928 PORTLAND AVE APT S411
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55404-3469
Practice Address - Country:US
Practice Address - Phone:612-227-6595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-31
Last Update Date:2023-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health