Provider Demographics
NPI:1811316730
Name:NUNO, ABDIRIZAK (MD)
Entity type:Individual
Prefix:MR
First Name:ABDIRIZAK
Middle Name:
Last Name:NUNO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ABDIRIZAK
Other - Middle Name:
Other - Last Name:NUNO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5270 WEST 84TH STREET
Mailing Address - Street 2:SUITE #370
Mailing Address - City:BLOOMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55437
Mailing Address - Country:US
Mailing Address - Phone:952-395-5222
Mailing Address - Fax:952-395-5333
Practice Address - Street 1:5270 WEST 84TH STREET
Practice Address - Street 2:SUITE #370
Practice Address - City:BLOOMINGTON
Practice Address - State:MN
Practice Address - Zip Code:55437
Practice Address - Country:US
Practice Address - Phone:952-395-5222
Practice Address - Fax:952-395-5333
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-08
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN611632084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN597452500Medicaid