Individual
MS. FADUMO OMAR ALI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 PARK AVENUE SOUTH, MINNEAPOLIS, MN 55404
(612) 879-8730
(612) 879-1335
Mailing address
3940 40TH AVENUE SOUTH, MINNEAPOLIS, MN 55406
(612) 728-1733
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
MN
Other
Enumeration date
09/30/2008
Last updated
09/30/2008
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