1265099907 NPI number — DR. SAMIA ABDULRAHIM HARKIN D.O.

Table of content: DR. SAMIA ABDULRAHIM HARKIN D.O. (NPI 1265099907)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265099907 NPI number — DR. SAMIA ABDULRAHIM HARKIN D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HARKIN
Provider First Name:
SAMIA
Provider Middle Name:
ABDULRAHIM
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ABDULRAHIM
Provider Other First Name:
SAMIHA
Provider Other Middle Name:
D'ANN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1265099907
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1801 HICKMAN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DES MOINES
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50314-1505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
515-282-5640
Provider Business Mailing Address Fax Number:
515-282-2332

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1801 HICKMAN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DES MOINES
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50314-1505
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
515-282-5640
Provider Business Practice Location Address Fax Number:
515-282-2332
Provider Enumeration Date:
05/28/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  R-11569 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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