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Individual

FADUMO HASSAN ISMAIL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
6545 FRANCE AVE S, EDINA, MN 55435-2131
(952) 848-5600
Mailing address
720 WASHINGTON AVE SE STE 200, MINNEAPOLIS, MN 55414-2924
(612) 884-0600

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
14972
MN
390200000X
Student in an Organized Health Care Education/Training Program
GA

Other

Enumeration date
09/22/2022
Last updated
11/19/2024
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