Basic Information
Provider Information
NPI: 1265099907
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HARKIN
FirstName: SAMIA
MiddleName: ABDULRAHIM
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ABDULRAHIM
OtherFirstName: SAMIHA
OtherMiddleName: D'ANN
OtherNamePrefix: DR.
OtherNameSuffix:  
OtherCredential: D.O.
OtherLastNameType: 1
Mailing Information
Address1: 1801 HICKMAN RD
Address2:  
City: DES MOINES
State: IA
PostalCode: 503141505
CountryCode: US
TelephoneNumber: 5152825640
FaxNumber: 5152822332
Practice Location
Address1: 1801 HICKMAN RD
Address2:  
City: DES MOINES
State: IA
PostalCode: 503141505
CountryCode: US
TelephoneNumber: 5152825640
FaxNumber: 5152822332
Other Information
ProviderEnumerationDate: 05/28/2019
LastUpdateDate: 01/26/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 01/26/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000XR-11569IAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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