Individual
IDMAN FAUZI AHMED
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1913 BROADWAY ST NE # 100, MINNEAPOLIS, MN 55413-2627
(763) 353-0763
(763) 260-9898
Mailing address
800 42ND AVE NE APT 405, MINNEAPOLIS, MN 55421-3717
(763) 353-0763
(763) 260-9898
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05636163
—
MN
Enumeration date
01/20/2026
Last updated
01/20/2026
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