Provider Demographics
NPI:1992136089
Name:ISSE, SULEIMAN MOHAMED (SULEIMAN)
Entity type:Individual
Prefix:
First Name:SULEIMAN
Middle Name:MOHAMED
Last Name:ISSE
Suffix:
Gender:M
Credentials:SULEIMAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4575 NATHAN LN N
Mailing Address - Street 2:# 102
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55442-3403
Mailing Address - Country:US
Mailing Address - Phone:763-458-1381
Mailing Address - Fax:
Practice Address - Street 1:4575 NATHAN LN N
Practice Address - Street 2:# 102
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55442-3403
Practice Address - Country:US
Practice Address - Phone:763-458-1381
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-27
Last Update Date:2013-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter