Provider Demographics
NPI:1952087520
Name:HUBLE, MOHAMED ABDIQADIR
Entity Type:Individual
Prefix:
First Name:MOHAMED
Middle Name:ABDIQADIR
Last Name:HUBLE
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:PO BOX 8327
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55408-0327
Mailing Address - Country:US
Mailing Address - Phone:619-317-8316
Mailing Address - Fax:
Practice Address - Street 1:2300 E FRANKLIN AVE # A312
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55406-1072
Practice Address - Country:US
Practice Address - Phone:619-317-8316
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-27
Last Update Date:2023-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide