Individual
VIDUR BHALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4320 WORNALL RD STE 512, KANSAS CITY, MO 64111-3235
(816) 932-8663
Mailing address
901 E 104TH ST, KANSAS CITY, MO 64131-4517
(816) 502-7000
(816) 932-7957
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
2017022363
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
IL
Other
Enumeration date
04/04/2012
Last updated
01/15/2019
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