Basic Information
| Provider Information | |||||||||
| NPI: | 1164545281 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AHMADIYEH | ||||||||
| FirstName: | NASIM | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2310 HOLMES ST | ||||||||
| Address2: | STE 800 | ||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641082602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8162182523 | ||||||||
| FaxNumber: | 8162856923 | ||||||||
| Practice Location | |||||||||
| Address1: | 2301 HOLMES ST | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641082640 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8164040099 | ||||||||
| FaxNumber: | 8164045381 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2007 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086X0206X | 04-37553 | KS | N | Allopathic & Osteopathic Physicians | Surgery | Surgical Oncology | 208600000X | 2017035457 | MO | Y | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 230857 | MA | N | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.