Mohamed Ahmed Aw-Dahir, RPH
Individual provider Active NPI Pharmacist · Eagan, MN
NPI 1063793545 · NPPES record last updated Aug 29, 2011
Key facts
- NPI
- 1063793545
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 117340 (MN)
- Practice address
- 2010 Cliff Rd
Eagan, MN 55122-2313 - Phone
- (651) 686-6940
- Fax
- (651) 686-1072
- NPI assigned
- Aug 29, 2011
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 117340 | MN | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 117340 | MN | Yes |
Addresses
Primary practice location
2010 Cliff Rd
Eagan, MN 55122-2313
Mailing address
7098 159TH St W
Apple Valley, MN 55124-5130
Phone (925) 200-5866
Other providers in Eagan, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 29, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.