Healthcare Provider Details

I. General information

NPI: 1508976549
Provider Name (Legal Business Name): ASHOK RAMCHANDINA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1337 S FOUNTAIN DR
OLATHE KS
66061-7205
US

IV. Provider business mailing address

2118 N KEENELAND CT
WICHITA KS
67206-4463
US

V. Phone/Fax

Practice location:
  • Phone: 913-397-7800
  • Fax:
Mailing address:
  • Phone: 316-631-3739
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number16528
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: