Basic Information
| Provider Information | |||||||||
| NPI: | 1477919090 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | AL-KHATEEB | ||||||||
| FirstName: | ANAS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 600 1ST ST NW | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | MASON CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 504012932 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6414286999 | ||||||||
| FaxNumber: | 6414286678 | ||||||||
| Practice Location | |||||||||
| Address1: | 1000 4TH ST SW | ||||||||
| Address2: | |||||||||
| City: | MASON CITY | ||||||||
| State: | IA | ||||||||
| PostalCode: | 504012800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6414286999 | ||||||||
| FaxNumber: | 6414286678 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/12/2016 | ||||||||
| LastUpdateDate: | 11/05/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RP1001X | 45739 | IA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.