Individual
ABDIWAHID ADAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
617 8TH AVE NW UNIT 334, NEW BRIGHTON, MN 55112-4149
(612) 220-0365
Mailing address
617 8TH AVE NW UNIT 334, NEW BRIGHTON, MN 55112-4149
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
F216072066209
—
Other
Enumeration date
08/15/2023
Last updated
08/15/2023
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