Healthcare Provider Details

I. General information

NPI: 1871716613
Provider Name (Legal Business Name): AHMED IBRAHIM AL-ABSI M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 12/06/2021
Certification Date: 12/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6530 TROOST AVE STE A
KANSAS CITY MO
64131-1301
US

IV. Provider business mailing address

6530 TROOST AVE STE A
KANSAS CITY MO
64131-1301
US

V. Phone/Fax

Practice location:
  • Phone: 816-361-0670
  • Fax: 816-444-6936
Mailing address:
  • Phone: 816-361-0670
  • Fax: 816-444-6936

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number2013011064
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number57083
License Number StateWI
# 3
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number2013011064
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: