Provider Demographics
NPI:1932576691
Name:HIRSI, ABDURAZAK
Entity Type:Individual
Prefix:MR
First Name:ABDURAZAK
Middle Name:
Last Name:HIRSI
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 1:2021 E HENNEPIN AVE
Mailing Address - Street 2:SUITE 402-5
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55413-2700
Mailing Address - Country:US
Mailing Address - Phone:612-999-1144
Mailing Address - Fax:612-284-7977
Practice Address - Street 1:2021 E HENNEPIN AVE
Practice Address - Street 2:SUITE 402-5
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55413-2700
Practice Address - Country:US
Practice Address - Phone:612-999-1144
Practice Address - Fax:612-284-7977
Is Sole Proprietor?:No
Enumeration Date:2015-08-28
Last Update Date:2015-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter