Provider Demographics
NPI:1811958689
Name:ABDULNABI, YOUSEF NMI (MD)
Entity type:Individual
Prefix:DR
First Name:YOUSEF
Middle Name:NMI
Last Name:ABDULNABI
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 1:10012 KENNERLY RD
Mailing Address - Street 2:#301
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63128
Mailing Address - Country:US
Mailing Address - Phone:314-729-0088
Mailing Address - Fax:314-729-3963
Practice Address - Street 1:10012 KENNERLY RD
Practice Address - Street 2:SUITE #301
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63128
Practice Address - Country:US
Practice Address - Phone:314-729-0088
Practice Address - Fax:314-729-3963
Is Sole Proprietor?:No
Enumeration Date:2006-03-31
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2009014851207RC0000X
WVWV19987174400000X
IL036-123864207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO209307305Medicaid
IL04232002OtherBCBSIL
MO000000639516OtherANTHEM - MISSOURI
4220632OtherCIGNA HMO PPO OPEN ACCESS
H67028Medicare UPIN
4220632OtherCIGNA HMO PPO OPEN ACCESS
MO1255387494Medicare PIN
MO000000639516OtherANTHEM - MISSOURI