Provider Demographics
NPI:1124006085
Name:DOSS, IHAB M (MD)
Entity Type:Individual
Prefix:DR
First Name:IHAB
Middle Name:M
Last Name:DOSS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:P.O. BOX 537
Mailing Address - Street 2:
Mailing Address - City:WARRENSBURG
Mailing Address - State:MO
Mailing Address - Zip Code:64093-0537
Mailing Address - Country:US
Mailing Address - Phone:660-262-7350
Mailing Address - Fax:660-262-7355
Practice Address - Street 1:407 BURKARTH ROAD
Practice Address - Street 2:SUITE 301
Practice Address - City:WARRENSBURG
Practice Address - State:MO
Practice Address - Zip Code:64093-3101
Practice Address - Country:US
Practice Address - Phone:660-262-7520
Practice Address - Fax:660-262-7437
Is Sole Proprietor?:No
Enumeration Date:2006-01-02
Last Update Date:2016-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009001285207L00000X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1124006085Medicaid
KS200260030AMedicaid
MO1124006085Medicaid