Individual
MS. IDIL ABDIRAHMAN MOHAMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
8170 OLD CARRIAGE CT STE 100, SHAKOPEE, MN 55379-3164
(952) 428-3600
(952) 428-3636
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
(612) 262-9000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11720
MN
363AM0700X
Medical Physician Assistant
11720
MN
363AS0400X
Surgical Physician Assistant
11720
MN
Other
Enumeration date
12/04/2014
Last updated
06/21/2024
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