Abdisamad Khalif Ali
Individual provider Active NPI Driver · Minneapolis, MN
NPI 1194410068 · NPPES record last updated Apr 11, 2023
Key facts
- NPI
- 1194410068
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- Practice address
- 5501 Nicollet Ave Apt 205
Minneapolis, MN 55419-1946 - Phone
- (206) 708-0478
- NPI assigned
- Apr 6, 2023
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Vida Transportation Service LLC | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | MN | Yes |
Addresses
Primary practice location
5501 Nicollet Ave Apt 205
Minneapolis, MN 55419-1946
Mailing address
5501 Nicollet Ave Apt 205
Minneapolis, MN 55419-1946
Phone (206) 708-0478
Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2023. 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.