Provider Demographics
NPI:1821607136
Name:ABDALLA, KHALID ABDULLATIF SADEQ (MD)
Entity Type:Individual
Prefix:MR
First Name:KHALID
Middle Name:ABDULLATIF SADEQ
Last Name:ABDALLA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:UNIVERSITY OF MISSOURI - KANSAS CITY SCHOOL OF MEDICINE
Mailing Address - Street 2:2411 HOLMS, M2-301, GRADUATE MEDICAL EDUCATION
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108
Mailing Address - Country:US
Mailing Address - Phone:816-235-6627
Mailing Address - Fax:816-235-6629
Practice Address - Street 1:TRUMAN MEDICAL CENTER
Practice Address - Street 2:2301 HOLMES ST., DEPT. OF INTERNAL MEDICINE
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108
Practice Address - Country:US
Practice Address - Phone:816-404-0957
Practice Address - Fax:816-404-0003
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-23
Last Update Date:2024-01-05
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Provider Licenses
StateLicense IDTaxonomies
MO20200165508390200000X
MO2020016508207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program