NPI 1417493990

Suado Hirsi Dirir

Practitioner Preferred Provider Organization Minneapolis, MN

Practice location

Address: 2605 Bloomington Ave, Minneapolis, MN 55407-1137
Phone: (612) 701-2772

Registered specialties

Preferred Provider Organization Primary

Managed Care Organizations Taxonomy 305R00000X Licence 1082425 (MN)

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Registry record

NPI: 1417493990
Entity type: Individual
Sex (as registered): Female
NPI issued: 9 Jan 2017
Record last updated: 9 Jan 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.