Healthcare Provider Details

I. General information

NPI: 1194811281
Provider Name (Legal Business Name): MAN M ANAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3515 S 4TH ST SUITE 100
LEAVENWORTH KS
66048-5013
US

IV. Provider business mailing address

7323 N NEVADA AVE
PARKVILLE MO
64152-1191
US

V. Phone/Fax

Practice location:
  • Phone: 913-651-2202
  • Fax: 913-273-1316
Mailing address:
  • Phone: 913-651-2202
  • Fax: 913-273-1316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number0420849
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR6E66
License Number StateMO
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number0420849
License Number StateKS
# 4
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberR6E66
License Number StateMO
# 5
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number0420849
License Number StateKS
# 6
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License NumberR6E66
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: