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General NPI Number Information
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NPI Number | 1093245979
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Entity Type | Organization
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Legal Business Name | ENDOCRINE CENTER OF KANSAS, LLC
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 9300 E 29TH ST N STE 204
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City | WICHITA
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State | KS
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Zip | 67226-2183
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Country | US
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Telephone | 316-500-6000
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Fax | 316-444-0409
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Provider Business Mailing Address
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Address Line | 9300 E 29TH ST N STE 204
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City | WICHITA
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State | KS
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Zip | 67226-2183
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Country | US
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Telephone | 316-500-6000
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Fax | 316-444-0409
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. RAMI MORTADA
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Credential | MD
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Telephone | 316-518-7737
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 04-35481
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License Number State | KS
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