Basic Information
| Provider Information | |||||||||
| NPI: | 1013979210 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABDOU | ||||||||
| FirstName: | NABIH | ||||||||
| MiddleName: | I | ||||||||
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| Credential: | M.D., PH. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4330 WORNALL RD | ||||||||
| Address2: | MED PLAZA II, 4TH FLOOR | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641113217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8165310930 | ||||||||
| FaxNumber: | 8167532671 | ||||||||
| Practice Location | |||||||||
| Address1: | 4330 WORNALL RD | ||||||||
| Address2: | MED PLAZA II, 4TH FLOOR | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641113217 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8165310930 | ||||||||
| FaxNumber: | 8167532671 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207KA0200X | R4J62 | MO | X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Allergy | 207KA0200X | 04-16092 | KS | X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Allergy | 207KI0005X | R4J62 | MO | X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Clinical & Laboratory Immunology | 207KI0005X | 04-16092 | KS | X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Clinical & Laboratory Immunology | 207RR0500X | R4J62 | MO | X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | 207RR0500X | 04-16092 | KS | X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology |
ID Information
| ID | Type | State | Issuer | Description | 05110011 | 01 | MO | BCBS | OTHER | 66329 | 01 | KS | BCBS | OTHER |