=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407802895
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALI SHWAIKI MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/26/2006
-----------------------------------------------------
Last Update Date | 09/03/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9100 W 74TH ST
-----------------------------------------------------
City | MERRIAM
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66204-4004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-632-9100
-----------------------------------------------------
Fax | 913-632-9159
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9100 W 74TH ST
-----------------------------------------------------
City | MERRIAM
-----------------------------------------------------
State | KS
-----------------------------------------------------
Zip | 66204-4004
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 913-632-9100
-----------------------------------------------------
Fax | 913-632-9159
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RX0202X
-----------------------------------------------------
Taxonomy Name | Medical Oncology Physician
-----------------------------------------------------
License Number | 2004017398
-----------------------------------------------------
License Number State | MO
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 207RX0202X
-----------------------------------------------------
Taxonomy Name | Medical Oncology Physician
-----------------------------------------------------
License Number | 31661
-----------------------------------------------------
License Number State | KS
-----------------------------------------------------