1932800562 NPI number — ABUBAKAR ABDIRASHID MENTAL HEALTH PRAC.

Table of content: ABUBAKAR ABDIRASHID MENTAL HEALTH PRAC. (NPI 1932800562)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932800562 NPI number — ABUBAKAR ABDIRASHID MENTAL HEALTH PRAC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABDIRASHID
Provider First Name:
ABUBAKAR
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MENTAL HEALTH PRAC.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932800562
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7180 TARTAN CURV
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EDEN PRAIRIE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55346-3902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-978-9373
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7180 TARTAN CURV
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EDEN PRAIRIE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55346-3902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-978-9373
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/10/2023

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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