Healthcare Provider Details

I. General information

NPI: 1114850294
Provider Name (Legal Business Name): MOHAMED ABDULLE
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/08/2026
Last Update Date: 06/08/2026
Certification Date: 06/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4193 SUMMIT DR
COLUMBUS OH
43224-6839
US

IV. Provider business mailing address

PO BOX 386
WESTERVILLE OH
43086-0386
US

V. Phone/Fax

Practice location:
  • Phone: 614-849-5711
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: