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General NPI Number Information
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NPI Number | 1750349080
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Entity Type | Individual
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Provider Name | RAJ SADASIVAN M.D., PHD
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Gender | Male
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Dates
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Enumeration Date | 05/03/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 4215 SHAWNEE DR
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City | KANSAS CITY
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State | KS
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Zip | 66106-3642
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Country | US
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Telephone | 913-236-6986
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Fax | 913-236-9681
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Provider Business Mailing Address
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Address Line | 4215 SHAWNEE DR
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City | KANSAS CITY
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State | KS
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Zip | 66106-3642
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Country | US
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Telephone | 913-236-6986
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Fax | 913-236-9681
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 0421612
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 111453
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License Number State | MO
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