Individual
JAMAL AHMAD IBDAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 S FAIRVIEW RD, COLUMBIA, MO 65203-7637
(573) 884-7600
(573) 884-8200
Mailing address
PO BOX 843966, KANSAS CITY, MO 64184-3966
(573) 884-3300
(573) 884-0943
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
2005016790
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
199404
BLUE SHIELD/BLUE CHOICE
MO
05
—
207486408
—
MO
01
—
712031
HEALTHLINK
MO
Enumeration date
05/05/2006
Last updated
09/02/2022
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