Provider Demographics
NPI:1932543717
Name:AZZAM, SARA DANIELLE (MD)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:DANIELLE
Last Name:AZZAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SARA
Other - Middle Name:DANIELLE
Other - Last Name:POWELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10787 NALL AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1371
Mailing Address - Country:US
Mailing Address - Phone:913-491-3300
Mailing Address - Fax:913-491-0904
Practice Address - Street 1:10787 NALL AVE STE 200
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1371
Practice Address - Country:US
Practice Address - Phone:913-491-3300
Practice Address - Fax:913-491-0904
Is Sole Proprietor?:No
Enumeration Date:2013-04-23
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0440173207RA0201X, 207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207RA0201XAllopathic & Osteopathic PhysiciansInternal MedicineAllergy & Immunology