Healthcare Provider Details

I. General information

NPI: 1639013931
Provider Name (Legal Business Name): ANUSHA GOPALAKRISHNAN IYER M.B.B.S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANUSHA GOPALAKRISHNAN M.B.B.S

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 NW MURRAY RD, STE 204
LEE'S SUMMIT MO
64081
US

IV. Provider business mailing address

600 NW MURRAY RD, STE 204
LEE'S SUMMIT MO
64081
US

V. Phone/Fax

Practice location:
  • Phone: 816-434-3633
  • Fax:
Mailing address:
  • Phone: 816-434-3633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: