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General NPI Number Information
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NPI Number | 1649653544
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Entity Type | Individual
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Provider Name | RAWAN T AL-ODAT M.D
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Gender | Female
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Dates
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Enumeration Date | 07/09/2015
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Last Update Date | 08/04/2020
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Provider Practice Location Address
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Address Line | 300 WERNER ST. CHI ST. VINCENT
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City | HOT SPRINGS
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State | AR
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Zip | 71913
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Country | US
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Telephone | 505-622-1000
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Fax |
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Provider Business Mailing Address
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Address Line | 9125 COPPER AVE NE APT. 516
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City | ALBUQUERQUE
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State | NM
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Zip | 87123
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Country | US
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Telephone | 505-353-1041
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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 | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | E-13224
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License Number State | AR
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