DR. SARFARAZ ABDEALI JASDANWALA (NPI# 1851646665) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851646665 |
| Entity Type | Individual |
| Full Name | DR. SARFARAZ ABDEALI JASDANWALA |
| Credential | MD |
| Practice Address |
1091 Midway Dr Linn Creek MO 65052-1687 |
| Mailing Address |
1800 Community Clinton MO 64735-8804 |
| Practice Telephone | 8884031071 |
| Mailing Telephone | 6608858131 |
| Enumeration Date | 2012-07-17 |
| Last Update Date | 2018-05-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 2015021629 | MO | Allopathic & Osteopathic Physicians |
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
2015021629 | MO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MO | CDS | 2500025774 | 01 |
| MO | STATE LICENSE | 2015021629 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 35629 Highway 72 Bldg 3, Salem, MO 655607217 | 5737298000 | 5737298001 |
| Street Address |
1091 MIDWAY DR |
| City | LINN CREEK |
| State | MO |
| Zip Code | 65052-1687 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285703736 | Carolyn Marie Baty | Counselor | 1091 Midway Dr, Linn Creek, MO 65052 | 2006-11-07 |
| 1306344544 | Ria Newcomb | Counselor | 1091 Midway Dr, Linn Creek, MO 65052 | 2018-01-23 |
| 1235660242 | Brook Lupplace | Registered Nurse | 1091 Midway Dr, Linn Creek, MO 65052-1687 | 2017-03-22 |
| 1811356124 | Kristy Gaines | Registered Nurse | 1091 Midway Dr, Linn Creek, MO 65052-1687 | 2016-02-15 |
| 1912335340 | Alison Meinecke | Counselor | 1091 Midway Dr, Linn Creek, MO 65052-1687 | 2013-10-22 |
| 1518309533 | Lindsey A Brown | Registered Nurse | 1091 Midway Dr, Linn Creek, MO 65052-1687 | 2013-07-18 |
| 1417398900 | Jennifer Wren Matthews | Registered Nurse | 1091 Midway Dr, Linn Creek, MO 65052-1687 | 2013-07-11 |
| 1447509948 | Mark A Kassebaum | Counselor | 1091 Midway Dr, Linn Creek, MO 65052-1687 | 2012-08-30 |
| 1639305147 | Karista E. Gill | Counselor | 1091 Midway Dr, Linn Creek, MO 65052-1687 | 2009-06-10 |
| 1437294816 | Family Counseling Center of Missouri Inc | Substance Abuse Rehabilitation Facility | 1091 Midway Dr, Linn Creek, MO 65052-1687 | 2007-02-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730597774 | Philip Cody Austin | Dentist | 4176 East Highway 54, Linn Creek, MO 65052 | 2014-07-22 |
| 1467450189 | Christi Michelle Hancock | Chiropractor | 4203 E Us Highway 54, Linn Creek, MO 65052-1745 | 2005-07-07 |
| 1851880314 | Brittney Laine Bennett | Chiropractor | 4203 E Us Highway 54, Linn Creek, MO 65052-1745 | 2018-05-09 |
| 1194998450 | Absolute Wellness Center, Inc | Chiropractor | 4203 E Us Highway 54, Linn Creek, MO 65052-1745 | 2008-04-08 |
| 1528113610 | Anita Pinson | Counselor | 326 Lowell Williams Rd, Linn Creek, MO 65052-1851 | 2007-01-25 |
| 1407994544 | Charles Leroy Dial | Podiatrist | 123 Biscayne Ln, Linn Creek, MO 65052-2507 | 2007-02-01 |
| 1215049788 | Charles J. Mcmullin Jr. | Specialist | 300 Foxhead Shores Dr, Linn Creek, MO 65052-2563 | 2006-08-31 |
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669540928 | Daniel Paul Windsor | Internal Medicine | 910 Brookwood Ctr, Fenton, MO 63026-3474 | 2006-12-02 |
| 1740436971 | Jorge F Kawano-castillo | Internal Medicine | 2301 Holmes St, Kansas City, MO 64108-2640 | 2008-08-07 |
| 1528192150 | Mark Luther Carlson | Internal Medicine | 1423 N Jefferson Ave, Springfield, MO 65802-1917 | 2007-03-15 |
| City | LINN CREEK |
| Zip Code | 65052 |
Please comment or provide details below to improve the information on DR. SARFARAZ ABDEALI JASDANWALA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.