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: 10/08/2024
Certification Date: 10/08/2024
Deactivation Date: 01/09/2019
Reactivation Date: 03/01/2019

III. Provider practice location address

2401 GILLHAM RD
KANSAS CITY MO
64108-4619
US

IV. Provider business mailing address

1 CHILDRENS PL CB 8116
SAINT LOUIS MO
63110
US

V. Phone/Fax

Practice location:
  • Phone: 816-701-5200
  • Fax: 816-302-9939
Mailing address:
  • Phone: 314-454-6095
  • Fax: 314-454-2561

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2021014976
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2021025592
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: