MEDICARE: SHEKHAR GUGNANI STUDENT

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1912780701
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHEKHAR GUGNANI STUDENT

Provider Business Mailing Address
First Line	:	2705 MCGEE TRFY APT 2402
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-3917
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2705 MCGEE TRFY APT 2402
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64108-3917
Country	:	US
Telephone Number	:	620-768-8098
Fax Number	:

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

Provider Enumeration Date	:	08/15/2023
Last Update Date	:	08/15/2023

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Directions to “ SHEKHAR GUGNANI STUDENT” Practice Location

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