Provider Demographics
NPI:1710770425
Name:BARAKI, ABDIWELI
Entity type:Individual
Prefix:
First Name:ABDIWELI
Middle Name:
Last Name:BARAKI
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 1:313 LITCHFIELD AVE SW APT 3
Mailing Address - Street 2:
Mailing Address - City:WILLMAR
Mailing Address - State:MN
Mailing Address - Zip Code:56201-3352
Mailing Address - Country:US
Mailing Address - Phone:320-894-4265
Mailing Address - Fax:
Practice Address - Street 1:313 LITCHFIELD AVE SW APT 3
Practice Address - Street 2:
Practice Address - City:WILLMAR
Practice Address - State:MN
Practice Address - Zip Code:56201-3352
Practice Address - Country:US
Practice Address - Phone:320-894-4265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNT080227134208172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver