Healthcare Provider Details

I. General information

NPI: 1811487515
Provider Name (Legal Business Name): RABAH DAOUD M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2018
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date: 01/09/2019
Reactivation Date: 03/01/2019

III. Provider practice location address

3243 E MURDOCK ST
WICHITA KS
67208-3052
US

IV. Provider business mailing address

2401 GILLHAM RD ATTN PROVIDER ENROLLMENT DEPT
KANSAS CITY MO
64108-4619
US

V. Phone/Fax

Practice location:
  • Phone: 316-500-8900
  • Fax:
Mailing address:
  • Phone: 816-701-5200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number04-50025
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number2021025592
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: