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General NPI Number Information
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NPI Number | 1629071881
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Entity Type | Individual
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Provider Name | FAHIMA A QALBANI M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/23/2005
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Last Update Date | 01/16/2008
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Provider Practice Location Address
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Address Line | 612 N SIOUX POINT RD STE 500
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City | DAKOTA DUNES
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State | SD
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Zip | 57049-5084
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Country | US
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Telephone | 605-232-6200
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Fax | 605-235-0004
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Provider Business Mailing Address
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Address Line | 612 N SIOUX POINT RD STE 500
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City | DAKOTA DUNES
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State | SD
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Zip | 57049-5084
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Country | US
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Telephone | 605-232-6200
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Fax | 605-235-0004
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 2590
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License Number State | SD
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Taxonomy #2
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number | 2590
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License Number State | SD
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