Healthcare Provider Details

I. General information

NPI: 1518989557
Provider Name (Legal Business Name): ARUNA BARATHAM M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 01/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8401 W 125TH ST
OVERLAND PARK KS
66213-1449
US

IV. Provider business mailing address

8401 W 125TH ST
OVERLAND PARK KS
66213-1449
US

V. Phone/Fax

Practice location:
  • Phone: 913-338-3222
  • Fax: 913-338-3227
Mailing address:
  • Phone: 913-338-3222
  • Fax: 913-338-3227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number04-431986
License Number StateKS
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number04-431986
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: