Healthcare Provider Details

I. General information

NPI: 1528443397
Provider Name (Legal Business Name): OSAMA METHQAL AHMAD DIAB M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2015
Last Update Date: 07/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 SHAWNEE MISSION PKWY STE 210
WESTWOOD KS
66205-2005
US

IV. Provider business mailing address

2330 SHAWNEE MISSION PKWY STE 210
WESTWOOD KS
66205-2005
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-0348
  • Fax:
Mailing address:
  • Phone: 913-588-0348
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number94-09444
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number7572
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: