MEDICARE: ABDIQADIR A ADAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	343900000X	Non-emergency Medical Transport (VAN)

General Provider Information

NPI Number	:	1952089872
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ABDIQADIR A ADAN

Provider Business Mailing Address
First Line	:	541 W LAPHAM BLVD APT 102
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53204-3419
Country	:	US
Telephone Number	:	414-213-0698
Fax Number	:

Provider Business Practice Location Address
First Line	:	541 W LAPHAM BLVD APT 102
Second Line	:
City	:	MILWAUKEE
State	:	WI
Zip	:	53204-3419
Country	:	US
Telephone Number	:	414-213-0698
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/10/2023
Last Update Date	:	07/10/2023

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Directions to “ ABDIQADIR A ADAN ” Practice Location

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