Provider Demographics
NPI:1225680630
Name:ANANI, ABEDEL RAHMAN FAWZI A
Entity type:Individual
Prefix:
First Name:ABEDEL RAHMAN
Middle Name:FAWZI A
Last Name:ANANI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 FARAON ST STE 210
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:MO
Mailing Address - Zip Code:64506-3800
Mailing Address - Country:US
Mailing Address - Phone:816-271-1385
Mailing Address - Fax:816-271-1379
Practice Address - Street 1:5301 FARAON ST STE 210
Practice Address - Street 2:
Practice Address - City:SAINT JOSEPH
Practice Address - State:MO
Practice Address - Zip Code:64506-3800
Practice Address - Country:US
Practice Address - Phone:816-271-1385
Practice Address - Fax:816-271-1379
Is Sole Proprietor?:No
Enumeration Date:2019-07-15
Last Update Date:2025-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024039995207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease