Provider Demographics
NPI:1326639295
Name:ABUSALIM, ALA NAIM (PA-C)
Entity Type:Individual
Prefix:
First Name:ALA
Middle Name:NAIM
Last Name:ABUSALIM
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4350 SHAWNEE MISSION PKWY
Mailing Address - Street 2:
Mailing Address - City:FAIRWAY
Mailing Address - State:KS
Mailing Address - Zip Code:66205-2528
Mailing Address - Country:US
Mailing Address - Phone:913-588-0970
Mailing Address - Fax:
Practice Address - Street 1:4350 SHAWNEE MISSION PKWY FL 3
Practice Address - Street 2:
Practice Address - City:FAIRWAY
Practice Address - State:KS
Practice Address - Zip Code:66205-2528
Practice Address - Country:US
Practice Address - Phone:913-588-0970
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-02
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
KS15-026752084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program