Healthcare Provider Details

I. General information

NPI: 1568022598
Provider Name (Legal Business Name): ARUNA DEEPTHI MARKONDA PATNAIK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/20/2019
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3243 E MURDOCK ST STE 401
WICHITA KS
67208-3007
US

IV. Provider business mailing address

3243 E MURDOCK ST STE 401
WICHITA KS
67208-3007
US

V. Phone/Fax

Practice location:
  • Phone: 316-682-5544
  • Fax: 316-682-9944
Mailing address:
  • Phone: 316-682-5544
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number94-09904
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License Number0449194
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: