Individual
ABDIFATAH SHARIFF OMAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2355 FAIRVIEW AVE N #182, ROSEVILLE, MN 55113
(612) 999-8057
Mailing address
2355 FAIRVIEW AVE N # 182, ROSEVILLE, MN 55113-2724
(612) 999-8057
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
10/16/2017
Last updated
07/21/2022
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