MEDICARE: DR. MATHURA ANANTHAN 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	207Q00000X	Family Medicine Physician	2026022105	MO

General Provider Information

NPI Number	:	1740111327
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MATHURA ANANTHAN MD

Provider Business Mailing Address
First Line	:	400 E RED BRIDGE RD STE 105
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-4029
Country	:	US
Telephone Number	:	816-214-5548
Fax Number	:

Provider Business Practice Location Address
First Line	:	400 E RED BRIDGE RD STE 105
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64131-4029
Country	:	US
Telephone Number	:	816-214-5548
Fax Number	:

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

Provider Enumeration Date	:	05/25/2026
Last Update Date	:	05/25/2026

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