Healthcare Provider Details

I. General information

NPI: 1952968919
Provider Name (Legal Business Name): NOURALDEEN ADNAN RASHED MANASRAH M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2019
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date: 01/16/2020
Reactivation Date: 01/28/2020

III. Provider practice location address

3901 RAINBOW BLVD # MS 3006
KANSAS CITY KS
66160-8500
US

IV. Provider business mailing address

3901 RAINBOW BLVD # MS 3006
KANSAS CITY KS
66160-8500
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-3827
  • Fax:
Mailing address:
  • Phone: 913-588-3827
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number9412546
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: