Healthcare Provider Details

I. General information

NPI: 1386634673
Provider Name (Legal Business Name): PRAVEEN KUMAR KHILNANI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/27/2005
Last Update Date: 07/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

929 N SAINT FRANCIS ST
WICHITA KS
67214-3821
US

IV. Provider business mailing address

B 42 PANCHSHEEL ENCLAVE
NEW DELHI DELHI
110017
IN

V. Phone/Fax

Practice location:
  • Phone: 316-268-5794
  • Fax: 316-291-7921
Mailing address:
  • Phone: 011919810159466
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License Number04-29988
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code2080P0203X
TaxonomyPediatric Critical Care Medicine Physician
License NumberME75965
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: