Provider Demographics
NPI:1770261893
Name:NUMAIR, IMAD N
Entity type:Individual
Prefix:
First Name:IMAD
Middle Name:N
Last Name:NUMAIR
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 1:12626 BALLENTINE ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-4505
Mailing Address - Country:US
Mailing Address - Phone:913-378-5002
Mailing Address - Fax:
Practice Address - Street 1:12626 BALLENTINE ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-4505
Practice Address - Country:US
Practice Address - Phone:913-378-5002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO043370183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist