Healthcare Provider Details

I. General information

NPI: 1841618733
Provider Name (Legal Business Name): AHMAD GHAITH TARAKJI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2014
Last Update Date: 07/14/2026
Certification Date: 07/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 CAMBRIDGE ST
KANSAS CITY KS
66160-8501
US

IV. Provider business mailing address

3901 RAINBOW BLVD MS 1020
KANSAS CITY KS
66160
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-1227
  • Fax:
Mailing address:
  • Phone: 913-588-6005
  • Fax: 913-588-3877

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number04-39900
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: