Individual
VIJAYA P SAMUEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
10601 QUIVIRA RD, SUITE 200, OVERLAND PARK, KS 66215-2310
(913) 541-3340
(913) 492-7857
Mailing address
10601 QUIVIRA RD, SUITE 200, OVERLAND PARK, KS 66215-2310
(913) 541-3340
(913) 492-7857
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-29522
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-29522
MEDICAL LICENSE
KS
05
—
100425510C
—
KS
05
—
1104810803
—
MO
Enumeration date
09/08/2005
Last updated
10/05/2009
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