Provider Demographics
NPI:1255949111
Name:AL-GHALAILAT, AMEER ATALLAH ABDELRAZEQ (MD)
Entity type:Individual
Prefix:MR
First Name:AMEER
Middle Name:ATALLAH ABDELRAZEQ
Last Name:AL-GHALAILAT
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:PO BOX 14001
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97309-5014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:TRUMAN MEDICAL CENTER
Practice Address - Street 2:2301 HOLMES ST. DEPT. OF 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:2020-07-16
Last Update Date:2023-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD213670207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine