Provider Demographics
NPI:1205622982
Name:ELMISBAH, HATIM ABDALA MOHAMEDSALIH
Entity type:Individual
Prefix:
First Name:HATIM
Middle Name:ABDALA MOHAMEDSALIH
Last Name:ELMISBAH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 WESTWINDS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-2756
Mailing Address - Country:US
Mailing Address - Phone:319-800-1697
Mailing Address - Fax:
Practice Address - Street 1:677 WESTWINDS DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-2756
Practice Address - Country:US
Practice Address - Phone:319-800-1697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-17
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)