Provider Demographics
NPI:1972308351
Name:GULED, ABDIRIZAK HERSI
Entity type:Individual
Prefix:
First Name:ABDIRIZAK
Middle Name:HERSI
Last Name:GULED
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6278 CHERYLBROOK LN
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-1900
Mailing Address - Country:US
Mailing Address - Phone:614-260-3477
Mailing Address - Fax:
Practice Address - Street 1:6278 CHERYLBROOK LN
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43017-1900
Practice Address - Country:US
Practice Address - Phone:614-260-3477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHSN498611146N00000X, 172A00000X, 372500000X, 372600000X, 3747A0650X, 171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171W00000XOther Service ProvidersContractorGroup - Multi-Specialty
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, BasicGroup - Multi-Specialty
No172A00000XOther Service ProvidersDriver
No372500000XNursing Service Related ProvidersChore ProviderGroup - Multi-Specialty
No372600000XNursing Service Related ProvidersAdult CompanionGroup - Multi-Specialty
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider