Abdalla, Yazan A
Abdalla, Yazan A is an individual health care provider with primary practice located at 10012 Kennerly Rd Suite 404, Saint Louis MO 63128-2197. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Gastroenterology. Allopathic & Osteopathic Physicians / Gastroenterology is his primary health care specialty. Abdalla, Yazan A can be contacted via phone (314) 543-5911.Contact Information
Primary practice address
10012 Kennerly Rd Suite 404
Saint Louis MO 63128-2197
Phone: (314) 543-5911
Fax: (314) 543-5914
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 2007016056 | Missouri |
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 2011014220 | Missouri |
Profile Details
| NPI number | 1033365358 |
|---|---|
| LBN Legal business name | Abdalla, Yazan A |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 18th, 2008 |
| Last updated | Mar 14th, 2017 - about 7 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033365358 | NPPES |
| Missouri | Other | 156440048 | MEDICARE PTAN # |
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