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General NPI Number Information
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NPI Number | 1710375175
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Entity Type | Organization
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Legal Business Name | KC INFECTIOUS DISEASE CONSULTANTS LLC
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Dates
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Enumeration Date | 01/07/2015
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Last Update Date | 07/07/2015
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Provider Practice Location Address
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Address Line | 7255 RENNER RD
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City | SHAWNEE
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State | KS
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Zip | 66217-3043
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Country | US
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Telephone | 913-631-0405
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Fax | 844-327-7237
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Provider Business Mailing Address
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Address Line | 7255 RENNER RD
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City | SHAWNEE
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State | KS
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Zip | 66217-3043
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Country | US
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Telephone | 913-631-0405
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Fax | 844-327-7237
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Authorized Official
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Title or Position | MD / PARTNER
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Name | SAMIR DESAI
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Credential | MD
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Telephone | 913-631-0504
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 0427706
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 0424938
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License Number State | KS
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