Basic Information
| Provider Information | |||||||||
| NPI: | 1003494113 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MKHAIMER | ||||||||
| FirstName: | YAMAN | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | AWS AL JAMAHI ST | ||||||||
| Address2: | 13 | ||||||||
| City: | AMMAN | ||||||||
| State: | JORDAN | ||||||||
| PostalCode: | 11941 | ||||||||
| CountryCode: | JO | ||||||||
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| Practice Location | |||||||||
| Address1: | 4401 WORNALL RD | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641113241 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8169322107 | ||||||||
| FaxNumber: | 8169322843 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/30/2021 | ||||||||
| LastUpdateDate: | 03/30/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/30/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.