Healthcare Provider Details

I. General information

NPI: 1730015934
Provider Name (Legal Business Name): ABDULQADIR AHMED
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/23/2026
Last Update Date: 06/23/2026
Certification Date: 06/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 BARNES CT # 1011
NORTH CONWAY NH
03860-5430
US

IV. Provider business mailing address

19 BARNES CT # 1011
NORTH CONWAY NH
03860-5430
US

V. Phone/Fax

Practice location:
  • Phone: 612-930-6608
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: