Healthcare Provider Details

I. General information

NPI: 1538252622
Provider Name (Legal Business Name): HASSAN SARADIH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10951 LAKEVIEW AVE STE A
LENEXA KS
66219-1331
US

IV. Provider business mailing address

PO BOX 16089
SHAWNEE KS
66203-6089
US

V. Phone/Fax

Practice location:
  • Phone: 913-553-0945
  • Fax:
Mailing address:
  • Phone: 913-634-3540
  • Fax: 913-825-6358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number04-27769
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number04-27769
License Number StateKS
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number04-27769
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: