Provider Demographics
NPI:1780067249
Name:ALAIHAIMIER, ADAM ISMAIL SR
Entity type:Individual
Prefix:MR
First Name:ADAM
Middle Name:ISMAIL
Last Name:ALAIHAIMIER
Suffix:SR
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 1:6603 QUEEN AVE S
Mailing Address - Street 2:6603 QUEEN AVE # J
Mailing Address - City:RICHFIELD
Mailing Address - State:MN
Mailing Address - Zip Code:55423-2037
Mailing Address - Country:US
Mailing Address - Phone:952-200-4210
Mailing Address - Fax:952-200-4219
Practice Address - Street 1:6603 QUEEN AVE S
Practice Address - Street 2:6603 QUEEN AVE S # J
Practice Address - City:RICHFIELD
Practice Address - State:MN
Practice Address - Zip Code:55423-2037
Practice Address - Country:US
Practice Address - Phone:952-200-4210
Practice Address - Fax:952-200-4210
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2015-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN347C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle