IndividualActive
Abdifatah Omar
NPI 1295246429 · Contractor · Roseville, MN
Provider details
- NPI number
- 1295246429
- Entity type
- Individual
- Primary specialty
- ContractorOther Service Providers
- Sex
- Male
- Sole proprietor
- Yes
Specialties & taxonomies
Other Service Providers
Practice location
2355 Fairview Ave N #182
Roseville, MN 55113
Phone: (612) 999-8057
Approximate (ZIP-level) locationGet directions
Mailing address
2355 Fairview Ave N # 182
Roseville, MN 55113-2724
Registry dates
- Enumerated
- 2017-10-16
- Last updated
- 2022-07-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.