Healthcare Provider Details

I. General information

NPI: 1548193063
Provider Name (Legal Business Name): TAHA ABDELHAMMED AWAD ABD ZIDAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2026
Last Update Date: 06/04/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 HOLMES ST
KANSAS CITY MO
64108
US

IV. Provider business mailing address

2411 HOLMES ST
KANSAS CITY MO
64108
US

V. Phone/Fax

Practice location:
  • Phone: 816-404-5275
  • Fax: 816-404-0003
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: