Healthcare Provider Details

I. General information

NPI: 1427552421
Provider Name (Legal Business Name): NAIMUL ALAM MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20375 W 151ST ST STE 301
OLATHE KS
66061-7207
US

IV. Provider business mailing address

20375 W 151ST ST STE 301
OLATHE KS
66061-7207
US

V. Phone/Fax

Practice location:
  • Phone: 913-588-0347
  • Fax: 913-588-6055
Mailing address:
  • Phone: 913-588-0347
  • Fax: 913-588-6055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number9412201
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberA165473
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: