Provider Demographics
NPI:1881443166
Name:AHMED, ABDIRAHMAN
Entity type:Individual
Prefix:
First Name:ABDIRAHMAN
Middle Name:
Last Name:AHMED
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 1:146 63RD WAY NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-4814
Mailing Address - Country:US
Mailing Address - Phone:612-224-0479
Mailing Address - Fax:
Practice Address - Street 1:146 63RD WAY NE
Practice Address - Street 2:
Practice Address - City:FRIDLEY
Practice Address - State:MN
Practice Address - Zip Code:55432-4814
Practice Address - Country:US
Practice Address - Phone:612-224-0479
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator