Provider Demographics
NPI:1982436374
Name:MAHAD, ADAN
Entity type:Individual
Prefix:
First Name:ADAN
Middle Name:
Last Name:MAHAD
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 1:1323 23RD ST S STE A&D
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-3759
Mailing Address - Country:US
Mailing Address - Phone:308-371-7093
Mailing Address - Fax:
Practice Address - Street 1:1323 23RD ST S STE D
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-3759
Practice Address - Country:US
Practice Address - Phone:308-371-7093
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-15
Last Update Date:2024-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management