Basic Information
Provider Information
NPI: 1063532240
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HAMID
FirstName: MALIK
MiddleName: ADAM
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 411851
Address2:  
City: KANSAS CITY
State: MO
PostalCode: 641411851
CountryCode: US
TelephoneNumber: 9132099084
FaxNumber:  
Practice Location
Address1: ANESTHESIOLOGY DEPT MSTP1034
Address2: 3901 RAINBOW BLVD
City: KANSAS CITY
State: KS
PostalCode: 661600001
CountryCode: US
TelephoneNumber: 9135886670
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/30/2007
LastUpdateDate: 07/18/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000X94-06232 TEMPORARYKSY Allopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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