Healthcare Provider Details

I. General information

NPI: 1740242114
Provider Name (Legal Business Name): MICHAEL M. VESALI MD, P.A
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

818 N EMPORIA ST SUITE 307
WICHITA KS
67214-3729
US

IV. Provider business mailing address

818 N EMPORIA ST SUITE 308
WICHITA KS
67214-3729
US

V. Phone/Fax

Practice location:
  • Phone: 316-264-7707
  • Fax: 316-264-7717
Mailing address:
  • Phone: 316-264-7707
  • Fax: 316-264-7717

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1200X
TaxonomySleep Disorder Diagnostic Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. MICHAEL M VESALI
Title or Position: OWNER
Credential: MD
Phone: 316-264-7707