Suad A Dhiisow

NPI #1700644473 in Columbia Heights, Minnesota

Provider Information

NPI Number: 1700644473
Entity Type: Individual
Name: Suad A Dhiisow
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Enumeration Date: Mar 7, 2024
Last Updated: Mar 7, 2024

Practice Location

Address: 1069 GRANDVIEW WAY # 143
City: Columbia Heights
State: Minnesota
ZIP Code: 55421-3376
Phone: (612) 403-1569

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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