Individual
ABDIRAZAK IBRAHIM ALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-1811
Mailing address
1025 MARSH ST, MANKATO, MN 56001-4752
(507) 625-1811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
33328
MN
390200000X
Student in an Organized Health Care Education/Training Program
33328
MN
Other
Enumeration date
04/17/2023
Last updated
05/25/2023
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