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1881661080

NPI Code Detail

MEDICARE: EVA VACHAL MD

MEDICARE: EVA VACHAL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207ZP0101X	Anatomic Pathology Physician	0417092	KS
2	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	0417092	KS
3	207ZP0105X	Clinical Pathology/Laboratory Medicine Physician	0417092	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	220016733	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	002058	OTHER	KS	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1881661080
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EVA VACHAL MD

Provider Business Mailing Address
First Line	:	PO BOX 1876
Second Line	:
City	:	WICHITA
State	:	KS
Zip	:	67201-1876
Country	:	US
Telephone Number	:	316-385-8428
Fax Number	:	316-652-0340

Provider Business Practice Location Address
First Line	:	401 E SPRUCE ST
Second Line	:
City	:	GARDEN CITY
State	:	KS
Zip	:	67846-5679
Country	:	US
Telephone Number	:	620-272-2222
Fax Number	:	316-652-0340

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/07/2006
Last Update Date	:	07/12/2010

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Directions to “ EVA VACHAL MD” Practice Location

Language	Start Address	Practice Location

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