Healthcare Provider Details

I. General information

NPI: 1154577310
Provider Name (Legal Business Name): OMAR ABDELAZIZ ABU NABA'A MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2008
Last Update Date: 09/14/2026
Certification Date: 09/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 SW 10TH AVE
TOPEKA KS
66604-1301
US

IV. Provider business mailing address

1500 SW 10TH AVE
TOPEKA KS
66604-1301
US

V. Phone/Fax

Practice location:
  • Phone: 785-354-5242
  • Fax: 785-354-6349
Mailing address:
  • Phone: 785-354-5242
  • Fax: 785-354-6349

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD2013-0824
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2024047121
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number04-38959
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: