Healthcare Provider Details
I. General information
NPI: 1922292630
Provider Name (Legal Business Name): ARCHANA GOVIND KULKARNI M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/06/2007
Last Update Date: 03/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
7900 LEES SUMMIT RD
KANSAS CITY MO
64139-1236
US
IV. Provider business mailing address
825 EUCLID AVE
KANSAS CITY MO
64124-2323
US
V. Phone/Fax
- Phone: 816-404-7100
- Fax:
- Phone: 816-474-4920
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | 2014029658 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | 2014029658 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: