Individual provider · NPI-1

Maryam Abdimalik Abdulahi

Clinic/Center · Minneapolis, MN

NPI number1316668981
StatusActive
Last updated in NPPESSep 12, 2022

Details

NPI
1316668981
Entity type
Individual (NPI-1)
Name
Maryam Abdimalik Abdulahi
Sex
Female
Sole proprietor
Yes
Enumeration date
Sep 12, 2022
Certification date
Sep 11, 2022
Last updated
Sep 12, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
261Q00000X Clinic/Center–MNYes

Practice location

4008 Minnehaha Ave
Minneapolis, MN 55406-3306

Phone 612-387-6968

Mailing address

4008 Minnehaha Ave
Minneapolis, MN 55406-3306

Phone 612-387-6968

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