Provider Demographics
NPI:1588473979
Name:ABDI, MUHIDIN AHMED
Entity type:Individual
Prefix:
First Name:MUHIDIN
Middle Name:AHMED
Last Name:ABDI
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 1:700 TWELVE OAKS CENTER DR STE 224
Mailing Address - Street 2:
Mailing Address - City:WAYZATA
Mailing Address - State:MN
Mailing Address - Zip Code:55391-4420
Mailing Address - Country:US
Mailing Address - Phone:763-353-9953
Mailing Address - Fax:
Practice Address - Street 1:700 TWELVE OAKS CENTER DR STE 224
Practice Address - Street 2:
Practice Address - City:WAYZATA
Practice Address - State:MN
Practice Address - Zip Code:55391-4420
Practice Address - Country:US
Practice Address - Phone:763-353-9953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-31
Last Update Date:2024-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNN474-110-073-115251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health