Healthcare Provider Details

I. General information

NPI: 1730044918
Provider Name (Legal Business Name): ABDIKHER HAJI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2025
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6385 OLD SHADY OAK RD STE 250
EDEN PRAIRIE MN
55344-7705
US

IV. Provider business mailing address

6385 OLD SHADY OAK RD STE 250
EDEN PRAIRIE MN
55344-7705
US

V. Phone/Fax

Practice location:
  • Phone: 612-394-4012
  • Fax: 651-358-2604
Mailing address:
  • Phone: 612-394-4012
  • Fax: 651-358-2604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: