Individual
DR. ABEDALRAHMAN H ITANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1001 E PRIMROSE ST, SPRINGFIELD, MO 65807-5155
(417) 875-3000
(417) 875-3922
Mailing address
1001 E PRIMROSE ST, SPRINGFIELD, MO 65807-5155
(417) 875-3000
(417) 875-3922
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
2004029639
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207460502
—
MO
Enumeration date
10/24/2006
Last updated
07/03/2012
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