Healthcare Provider Details

I. General information

NPI: 1033341912
Provider Name (Legal Business Name): RISHI RAM ADHIKARI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2009
Last Update Date: 04/18/2023
Certification Date: 04/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10100 E SHANNON WOODS CIR STE 108
WICHITA KS
67226-4106
US

IV. Provider business mailing address

10100 E SHANNON WOODS CIR STE 108
WICHITA KS
67226-4106
US

V. Phone/Fax

Practice location:
  • Phone: 316-282-3443
  • Fax:
Mailing address:
  • Phone: 316-282-3443
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number62798
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number036.130718
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number04-37817
License Number StateKS
# 4
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License Number04-37817
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: