MEDICARE: SHYAM M SHRIDHARANI MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207XS0117X	Orthopaedic Surgery of the Spine Physician	46861	MN
2	207XS0117X	Orthopaedic Surgery of the Spine Physician	04-43974	KS
3	207X00000X	Orthopaedic Surgery Physician	46861	MN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1730168626
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHYAM M SHRIDHARANI MD

Provider Business Mailing Address
First Line	:	20375 W 151ST ST STE 105
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66061-5353
Country	:	US
Telephone Number	:	913-355-8100
Fax Number	:	913-303-5510

Provider Business Practice Location Address
First Line	:	20375 W 151ST ST STE 105
Second Line	:
City	:	OLATHE
State	:	KS
Zip	:	66061-5353
Country	:	US
Telephone Number	:	913-355-8100
Fax Number	:	913-303-5510

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/10/2006
Last Update Date	:	11/12/2021

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Directions to “ SHYAM M SHRIDHARANI MD” Practice Location

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