Provider Demographics
NPI:1831154210
Name:ASLAMI, AHMAD W (DO)
Entity type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:W
Last Name:ASLAMI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1280 W US HIGHWAY 40
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:MO
Mailing Address - Zip Code:64076-9612
Mailing Address - Country:US
Mailing Address - Phone:816-633-5774
Mailing Address - Fax:816-633-5936
Practice Address - Street 1:1280 W US HIGHWAY 40
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:MO
Practice Address - Zip Code:64076-9612
Practice Address - Country:US
Practice Address - Phone:816-633-5774
Practice Address - Fax:816-633-5936
Is Sole Proprietor?:No
Enumeration Date:2006-04-19
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2001018644207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO595956103Medicaid
34695011OtherBCBS
MO245361019Medicaid
MO540568508Medicaid
MO010568509Medicaid
MO595985805Medicaid
261320Medicare PIN
MO245361019Medicaid
MO595985805Medicaid
268550Medicare Oscar/Certification
P270000Medicare PIN
G96439Medicare UPIN
MO010568509Medicaid