Individual
MOHAMED A HAGI ADEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
640 JACKSON STREET, ST PAUL, MN 55101-2502
(123) 123-1234
(651) 254-3662
Mailing address
8100 34 AVE S, MC21110Q, BLOOMINGTON, MN 55425-1672
(123) 123-1234
(651) 254-3662
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
47930
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
274661100
—
MN
Enumeration date
02/01/2006
Last updated
08/14/2008
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