NPI 1720405608

Ahmed Jama Botan

Practitioner Private Vehicle Minneapolis, MN

Practice location

Address: 419 Cedar Ave S APT G278, Minneapolis, MN 55454-1032
Phone: (612) 765-3202
Mailing address: 1615 S 4th St APT 3510, Minneapolis, MN 55454-1129

Registered specialties

Private Vehicle Primary

Transportation Services Taxonomy 347C00000X

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Registry record

NPI: 1720405608
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Mar 2014
Record last updated: 28 Mar 2014

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.