Provider Demographics
NPI:1083420392
Name:MOHAMUD, MUNA DAHIR
Entity type:Individual
Prefix:
First Name:MUNA
Middle Name:DAHIR
Last Name:MOHAMUD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 PLAZA DR STE 17
Mailing Address - Street 2:
Mailing Address - City:EAGAN
Mailing Address - State:MN
Mailing Address - Zip Code:55122-2613
Mailing Address - Country:US
Mailing Address - Phone:612-716-8019
Mailing Address - Fax:651-372-4200
Practice Address - Street 1:1875 PLAZA DR STE 17
Practice Address - Street 2:
Practice Address - City:EAGAN
Practice Address - State:MN
Practice Address - Zip Code:55122-2613
Practice Address - Country:US
Practice Address - Phone:612-716-8019
Practice Address - Fax:651-372-4200
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-10
Last Update Date:2024-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health