Individual
SHAFI MOHAMUD MOHAMED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
113 11TH AVE N, WAITE PARK, MN 56387-1026
(612) 636-9009
Mailing address
113 11TH AVE N, WAITE PARK, MN 56387-1026
(612) 636-9009
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
S069127180515
MN
Other
Enumeration date
01/18/2017
Last updated
01/18/2017
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