Provider Demographics
NPI:1841460250
Name:NABIL N FALTAS, MD, PC
Entity type:Organization
Organization Name:NABIL N FALTAS, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NABIL
Authorized Official - Middle Name:N
Authorized Official - Last Name:FALTAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:515-226-7423
Mailing Address - Street 1:610 10TH ST
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:IA
Mailing Address - Zip Code:50220-2221
Mailing Address - Country:US
Mailing Address - Phone:515-226-7423
Mailing Address - Fax:515-226-8506
Practice Address - Street 1:6000 UNIVERSITY AVE
Practice Address - Street 2:SUITE 140
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8203
Practice Address - Country:US
Practice Address - Phone:515-226-2122
Practice Address - Fax:515-226-8506
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-03
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA197072085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0299305Medicaid
IAA01059Medicare UPIN
IA0299305Medicaid