Healthcare Provider Details

I. General information

NPI: 1669525812
Provider Name (Legal Business Name): ASHUTOSH V BAPAT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2007
Last Update Date: 02/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20805 W 151ST ST SUITE 400
OLATHE KS
66061-7249
US

IV. Provider business mailing address

20805 W 151ST ST SUITE 400
OLATHE KS
66061-7249
US

V. Phone/Fax

Practice location:
  • Phone: 913-780-4900
  • Fax: 913-780-0949
Mailing address:
  • Phone: 913-780-4900
  • Fax: 913-780-0949

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number2011009904
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number04-34955
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: