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General NPI Number Information
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NPI Number | 1487006672
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Entity Type | Individual
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Provider Name | OBADA TAYYEM MD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2016
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Last Update Date | 10/25/2023
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Provider Practice Location Address
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Address Line | 3121 N WEBB RD
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City | WICHITA
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State | KS
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Zip | 67226-8119
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Country | US
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Telephone | 316-928-8930
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Fax | 316-261-3275
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Provider Business Mailing Address
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Address Line | 3121 N WEBB RD STE 101
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City | WICHITA
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State | KS
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Zip | 67226-8119
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Country | US
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Telephone | 316-261-3130
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Fax | 316-261-3275
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 04-45885
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License Number State | KS
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