Individual
SUADO HIRSI DIRIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2605 BLOOMINGTON AVE, MINNEAPOLIS, MN 55407-1137
(612) 701-2772
Mailing address
2605 BLOOMINGTON AVE, MINNEAPOLIS, MN 55407-1137
(612) 701-2772
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
1082425
MN
Other
Enumeration date
01/09/2017
Last updated
01/09/2017
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