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General NPI Number Information
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NPI Number | 1184660938
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Entity Type | Individual
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Provider Name | MOHAN R HINDUPUR M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 11/21/2017
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Provider Practice Location Address
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Address Line | 5514 CORPORATE DR STE 150
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City | SAINT JOSEPH
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State | MO
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Zip | 64507-7752
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Country | US
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Telephone | 816-271-1291
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Fax | 816-271-4062
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Provider Business Mailing Address
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Address Line | 5514 CORPORATE DR STE 150
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City | SAINT JOSEPH
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State | MO
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Zip | 64507-7763
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Country | US
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Telephone | 816-271-1265
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Fax | 816-271-4062
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | R7G44
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License Number State | MO
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