Provider Demographics
NPI:1710375175
Name:KC INFECTIOUS DISEASE CONSULTANTS LLC
Entity type:Organization
Organization Name:KC INFECTIOUS DISEASE CONSULTANTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD / PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SAMIR
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-631-0504
Mailing Address - Street 1:7255 RENNER RD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66217-3043
Mailing Address - Country:US
Mailing Address - Phone:913-631-0405
Mailing Address - Fax:844-327-7237
Practice Address - Street 1:7255 RENNER RD
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66217-3043
Practice Address - Country:US
Practice Address - Phone:913-631-0405
Practice Address - Fax:844-327-7237
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-07
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0427706207RI0200X
KS0424938207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty