Healthcare Provider Details

I. General information

NPI: 1790712750
Provider Name (Legal Business Name): TAREK DARWISH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11661 COLLEGE BLVD STE 100
OVERLAND PARK KS
66210-4104
US

IV. Provider business mailing address

11661 COLLEGE BLVD STE 100
OVERLAND PARK KS
66210-4104
US

V. Phone/Fax

Practice location:
  • Phone: 913-495-5517
  • Fax:
Mailing address:
  • Phone: 913-495-5517
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number2006038815
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: