Basic Information
| Provider Information | |||||||||
| NPI: | 1871156315 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ABDULRAHIM | ||||||||
| FirstName: | AHMED | ||||||||
| MiddleName: | HISHAM MOHAMMED | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 802843 | ||||||||
| Address2: | |||||||||
| City: | KANSAS CITY | ||||||||
| State: | MO | ||||||||
| PostalCode: | 641802843 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4177306430 | ||||||||
| FaxNumber: | 4172697567 | ||||||||
| Practice Location | |||||||||
| Address1: | 3801 S NATIONAL AVE STE 1122 | ||||||||
| Address2: | |||||||||
| City: | SPRINGFIELD | ||||||||
| State: | MO | ||||||||
| PostalCode: | 658076090 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4172697728 | ||||||||
| FaxNumber: | 4172697729 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/19/2019 | ||||||||
| LastUpdateDate: | 07/26/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/26/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 2022027889 | MO | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.