Dahir Sharif Abdiwahab

Individual provider Active NPI Health Service Clinic/Center · Fridley, MN

NPI 1295448694 · NPPES record last updated Dec 30, 2022

Key facts

NPI
1295448694
Entity type
Individual (NPI type 1)
Primary specialty
Health Service Clinic/Center 261QH0100X
Practice address
6260 Highway 65 NE Ste 303
Fridley, MN 55432-5150
Phone
(651) 734-3031
NPI assigned
Dec 30, 2022
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Health Service Clinic/Center 261QH0100X Yes

Addresses

Primary practice location

6260 Highway 65 NE Ste 303
Fridley, MN 55432-5150

Mailing address

778 Berry St Apt 220
Saint Paul, MN 55114-0013
Phone (651) 734-3031

Electronic endpoints

TypeEndpointUseAffiliation
CONNECT URL a Direct

Other providers in Fridley, MN

All providers in Fridley, MN · Health Service Clinic/Center in Minnesota

Sources for this page

Verify at the official NPI Registry.