Provider Demographics
NPI:1962591800
Name:FALTAS, NABIL NAKHLA (MD)
Entity type:Individual
Prefix:
First Name:NABIL
Middle Name:NAKHLA
Last Name:FALTAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 10TH STREET
Mailing Address - Street 2:DALLAS CO HOSPITAL
Mailing Address - City:PERRY
Mailing Address - State:IA
Mailing Address - Zip Code:50220
Mailing Address - Country:US
Mailing Address - Phone:515-465-7662
Mailing Address - Fax:515-465-2922
Practice Address - Street 1:610 10TH STREET
Practice Address - Street 2:DALLAS CO HOSPITAL
Practice Address - City:PERRY
Practice Address - State:IA
Practice Address - Zip Code:50220
Practice Address - Country:US
Practice Address - Phone:515-465-7662
Practice Address - Fax:515-465-2922
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA197072085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA5099564Medicaid
IA5099564Medicaid
IAA01059Medicare UPIN