Healthcare Provider Details

I. General information

NPI: 1629200779
Provider Name (Legal Business Name): AMITA VASUDEVA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2009
Last Update Date: 03/04/2026
Certification Date: 03/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 E MEYER BLVD, BLDG 2 SUITE
KANSAS CITY MO
64132
US

IV. Provider business mailing address

2340 E MEYER BLVD, BLDG 2 SUITE
KANSAS CITY MO
64132
US

V. Phone/Fax

Practice location:
  • Phone: 816-276-1700
  • Fax: 816-276-1703
Mailing address:
  • Phone: 816-276-1700
  • Fax: 816-276-1703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number2017033085
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: