Individual
AL MAMON ABU GHANIMAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 SW 10TH AVE, TOPEKA, KS 66604-1301
(785) 354-5242
Mailing address
1500 SW 10TH AVE, TOPEKA, KS 66604-1301
(785) 354-5242
Taxonomy
Speciality
Code
Description
License number
State
208M00000X
Hospitalist Physician
Primary
04-37184
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
068002266
MEDICARE PTAN
KS
05
—
201100090A
—
KS
05
—
30004272600001
—
KS
Enumeration date
09/09/2011
Last updated
12/04/2025
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