Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | 04-16092 | KS |
N | 207KA0200X | Allergist | R4J62 | MO |
N | 207RR0500X | Rheumatology | 04-16092 | KS |
N | 207RR0500X | Rheumatology | R4J62 | MO |
NPI | 1013979210 |
---|---|
Provider Name | Nabih I Abdou |
First Address | Kansas City, MO 64111-3217 |
Second Address | Kansas City, MO 64111-3217 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
05110011 | BCBS (01) | MO |
66329 | BCBS (01) | KS |
D16881 | (02) |