Provider Demographics
NPI:1700683836
Name:KASIM, ABDI
Entity type:Individual
Prefix:
First Name:ABDI
Middle Name:
Last Name:KASIM
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 1:5909 MAIN ST NE
Mailing Address - Street 2:
Mailing Address - City:FRIDLEY
Mailing Address - State:MN
Mailing Address - Zip Code:55432-5442
Mailing Address - Country:US
Mailing Address - Phone:404-860-9503
Mailing Address - Fax:
Practice Address - Street 1:510 S HAMILTON RD APT 23
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43213-2075
Practice Address - Country:US
Practice Address - Phone:614-806-5315
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-26
Last Update Date:2025-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3256HHN251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health