Healthcare Provider Details

I. General information

NPI: 1720574551
Provider Name (Legal Business Name): SYEDA SABEEKA BATOOL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/04/2018
Last Update Date: 09/20/2024
Certification Date: 09/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 S CLIFTON AVE STE 205
WICHITA KS
67218-2958
US

IV. Provider business mailing address

1515 S CLIFTON AVE STE 205
WICHITA KS
67218-2958
US

V. Phone/Fax

Practice location:
  • Phone: 313-274-8188
  • Fax: 316-274-8180
Mailing address:
  • Phone: 313-274-8188
  • Fax: 316-274-8180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number04-49785
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: