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Individual

KAHIYE AMIN SR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
122 23RD ST S, FARGO, ND 58103-1300
(619) 405-8308
Mailing address
801 44TH AVE S APT 113, MOORHEAD, MN 56560-6899
(619) 405-8308

Taxonomy

Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
ND
253Z00000X
In Home Supportive Care Agency
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
472804258
ND
Enumeration date
12/09/2014
Last updated
11/19/2020
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