Provider Demographics
NPI:1780849539
Name:TABBOSHA, MONIR (MD)
Entity type:Individual
Prefix:
First Name:MONIR
Middle Name:
Last Name:TABBOSHA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:MS 400
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:816-932-6433
Mailing Address - Fax:
Practice Address - Street 1:4320 WORNALL RD STE 710
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3246
Practice Address - Country:US
Practice Address - Phone:816-932-2700
Practice Address - Fax:816-932-2705
Is Sole Proprietor?:No
Enumeration Date:2008-07-22
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE8249207T00000X
OH35.130725207T00000X
MO2024037301207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery