Provider Demographics
NPI:1306287578
Name:MAHDI, ABDI R
Entity type:Individual
Prefix:MR
First Name:ABDI
Middle Name:R
Last Name:MAHDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3334 W MAIN ST # 179
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-4805
Mailing Address - Country:US
Mailing Address - Phone:405-808-4851
Mailing Address - Fax:
Practice Address - Street 1:3334 W MAIN ST # 179
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-4805
Practice Address - Country:US
Practice Address - Phone:405-808-4851
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-16
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator