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Individual

MR. ABDIFATAH OSMAN HUSSEIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1701 AMERICAN BLVD E STE 16, BLOOMINGTON, MN 55425-1401
(612) 605-1621
(612) 605-1631
Mailing address
1701 AMERICAN BLVD E STE 16, BLOOMINGTON, MN 55425-1401
(612) 605-1621
(612) 605-1631

Taxonomy

Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
D000-121-407-200
MN

Other

Enumeration date
02/27/2024
Last updated
02/27/2024
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