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General NPI Number Information
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NPI Number | 1063204527
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Entity Type | Organization
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Legal Business Name | PEAR SUITE PROVIDER GROUP KS, P.A.
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Dates
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Enumeration Date | 05/20/2025
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Last Update Date | 05/20/2025
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Provider Practice Location Address
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Address Line | 12345 W 95TH ST FL 2
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City | LENEXA
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State | KS
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Zip | 66215-3853
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Country | US
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Telephone | 213-277-7340
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Fax |
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Provider Business Mailing Address
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Address Line | 12345 W 95TH ST FL 2
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City | LENEXA
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State | KS
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Zip | 66215-3853
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Country | US
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Telephone | 213-277-7340
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. VIKRAM BAKHRU
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Credential | MD
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Telephone | 213-277-7340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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