Doctor Name: | AHMED JAMA BOTAN |
NPI Number: | 1720405608 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | |
Business Practice Address: | 419 Cedar Ave S Apt G278 Minneapolis, MN - 554541032 |
Business Phone Number: | 6127653202 |
Business Fax Number: | |
Mailing Address: | 1615 S 4th St Apt 3510, MINNEAPOLIS |
State: | MN |
Postal Code: | 554541129 |
Phone Number: | 6127653202 |
Fax Number: | |
NPI Enumeration Date: | 03/28/2014 |
NPI Last Update Date: | 03/28/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 347C00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Transportation Services |
Taxonomy Classification: | Private Vehicle |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual paid to provide non-emergency transportation using their privately owned/leased vehicle. |