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General NPI Number Information
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NPI Number | 1710444146
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Entity Type | Individual
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Provider Name | ABDI FATAH
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Gender | Male
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Dates
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Enumeration Date | 02/21/2019
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Last Update Date | 11/04/2023
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Provider Practice Location Address
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Address Line | 7201 YORK AVE S APT 817
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City | EDINA
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State | MN
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Zip | 55435-4446
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Country | US
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Telephone | 612-816-9090
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Fax | 612-500-4456
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Provider Business Mailing Address
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Address Line | 7220 YORK AVE S STE 817
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City | MINNEAPOLIS
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State | MN
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Zip | 55435-4495
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Country | US
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Telephone | 612-816-9093
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Fax | 612-500-4456
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172A00000X
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Taxonomy Name | Driver
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License Number |
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License Number State |
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