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General NPI Number Information
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NPI Number | 1497979678
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Entity Type | Individual
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Provider Name | AJJAI SHIVARAM ALVA M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 10701 NALL AVE STE 100
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City | OVERLAND PARK
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State | KS
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Zip | 66211-1244
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Country | US
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Telephone | 913-338-5585
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Fax | 913-338-3228
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Provider Business Mailing Address
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Address Line | 10701 NALL AVE STE 100
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City | OVERLAND PARK
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State | KS
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Zip | 66211-1244
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Country | US
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Telephone | 913-338-5585
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Fax |
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4301089564
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number | 4301089564
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 4301089564
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License Number State | MI
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Taxonomy #4
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 04-50975
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License Number State | KS
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