Individual
IMAD I NASSIF
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9050 E 29TH ST N STE 100, WICHITA, KS 67226-2187
(316) 219-9651
(316) 219-9655
Mailing address
9050 E 29TH ST N STE 100, WICHITA, KS 67226-2187
(316) 219-9651
(316) 219-9655
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0428527
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003616808
—
KS
01
—
102935
BLUE CROSS BLUE SHIELD
—
Enumeration date
02/24/2006
Last updated
04/02/2026
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