Basic Information
Provider Information
NPI: 1134409105
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ALHAFEZ
FirstName: ASHRAF
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
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OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1500 SW 10TH AVE
Address2: STORMONT-VAIL HEALTH CARE
City: TOPEKA
State: KS
PostalCode: 66604
CountryCode: US
TelephoneNumber: 7853545242
FaxNumber: 7853546349
Practice Location
Address1: 1500 SW 10TH AVE
Address2: STORMONT-VAIL HEALTH CARE
City: TOPEKA
State: KS
PostalCode: 66604
CountryCode: US
TelephoneNumber: 7853545242
FaxNumber: 7853546349
Other Information
ProviderEnumerationDate: 08/23/2011
LastUpdateDate: 03/04/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/04/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208M00000X04-37129KSY Allopathic & Osteopathic PhysiciansHospitalist 

No ID Information.


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