Doctor Name: | MAISA ISMAIL ABDALLA |
NPI Number: | 1669645222 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | M.D. |
License Number: | |
Business Practice Address: | 4440 W 95th St Room 131 North Oak Lawn, IL - 604532600 |
Business Phone Number: | 7086845673 |
Business Fax Number: | 7086842500 |
Mailing Address: | 1735 Haas Dr, KANSAS CITY |
State: | KS |
Postal Code: | 661062917 |
Phone Number: | 9132177454 |
Fax Number: | |
NPI Enumeration Date: | 04/03/2008 |
NPI Last Update Date: | 04/03/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |