Individual
NIVEDITA GANGULY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3901 RAINBOW BOULEVARD, 6067 DELP, MAIL STOP 1028, KANSAS CITY, KS 66160
(913) 588-6035
(913) 945-6916
Mailing address
3901 RAINBOW BOULEVARD, 6067 DELP, MAIL STOP 1028, KANSAS CITY, KS 66160
(913) 588-6035
(913) 945-6916
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
32986
KS
207RI0200X
Infectious Disease Physician
Primary
32986
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-32986
MEDICAL LICENSE NUMBER
KS
05
—
200623410A
—
KS
Enumeration date
04/26/2007
Last updated
05/08/2014
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