Individual
AHMAD AL-MUBASLAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
901 HEARTLAND RD STE 4810, SAINT JOSEPH, MO 64506-6202
(816) 271-1343
(816) 271-1321
Mailing address
1000 CARONDELET DR, PROVIDER ENROLLMENT/ MEDICAL STAFF OFFICE, KANSAS CITY, MO 64114
(816) 943-5744
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2009036449
MO
207R00000X
Internal Medicine Physician
SC27767
SC
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
2009036449
MO
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
41721
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1255328738
—
MO
Enumeration date
09/30/2005
Last updated
02/01/2021
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