Provider Demographics
NPI:1316391246
Name:FAKHANI, IMAD (MD)
Entity Type:Individual
Prefix:
First Name:IMAD
Middle Name:
Last Name:FAKHANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3611 N RUSHWOOD CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226-2520
Mailing Address - Country:US
Mailing Address - Phone:316-990-1594
Mailing Address - Fax:
Practice Address - Street 1:OUD METHA STREET
Practice Address - Street 2:AMERICAN HOSPITAL
Practice Address - City:DUBAI
Practice Address - State:DUBAI
Practice Address - Zip Code:5566
Practice Address - Country:AE
Practice Address - Phone:009714-377-6645
Practice Address - Fax:009714-377-6272
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2016-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS0426777207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine