Individual
MR. KADIR ISMAIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1821 UNIVERSITY AVE W STE 461, SAINT PAUL, MN 55104-2807
(602) 639-2550
Mailing address
1821 UNIVERSITY AVE W STE 461, SAINT PAUL, MN 55104-2807
(602) 639-2550
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
871745552
—
MN
Enumeration date
08/13/2021
Last updated
08/13/2021
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