Healthcare Provider Details

I. General information

NPI: 1114181302
Provider Name (Legal Business Name): FADI HAMID M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/16/2008
Last Update Date: 02/01/2026
Certification Date: 01/13/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

802 N RIVERSIDE RD STE 220
SAINT JOSEPH MO
64507-2509
US

IV. Provider business mailing address

901 E 104TH ST MAILSTOP 400N
KANSAS CITY MO
64131-4517
US

V. Phone/Fax

Practice location:
  • Phone: 816-271-7074
  • Fax: 813-385-8083
Mailing address:
  • Phone: 816-502-8755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number2007016499
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number2014032525
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: