Individual
DASA V GANGADHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
655 N WOODLAWN, WICHITA, KS 67206
(316) 684-5158
(316) 681-1005
Mailing address
1851 N WEBB RD, ATTN FLR2, WICHITA, KS 67206-3413
(316) 636-2010
(316) 858-3830
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0425003
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100163760B
—
KS
01
—
180024494
RAILROAD MEDICARE
KS
Enumeration date
02/21/2006
Last updated
02/26/2009
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