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General NPI Number Information
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NPI Number | 1578912572
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Entity Type | Individual
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Provider Name | AHMED EID SOBHY ABDELKADER MD
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Gender | Male
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 06/30/2025
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Provider Practice Location Address
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Address Line | 15740 S OUTER 40 RD
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City | CHESTERFIELD
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State | MO
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Zip | 63017-2004
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Country | US
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Telephone | 636-237-4699
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 227
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City | WILLOW SPRINGS
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State | IL
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Zip | 60480-0227
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Country | US
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Telephone |
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Fax |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | TP227
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | 32256
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 2084N0600X
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Taxonomy Name | Clinical Neurophysiology Physician
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License Number | 036158535
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License Number State | IL
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