Organization
GASTON I. S. DIALLO, MD, PA
Active
Other names
Gaston I. Saliou-Diallo, MD
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GASTON I. S. DIALLO M.D. (GASTROENTEROLOGIST)
(913) 682-9030
Entity
Organization
Contact information
Practice address
113 DELAWARE ST, SUITE E, LEAVENWORTH, KS 66048-2822
(913) 682-9030
Mailing address
113 DELAWARE ST, SUITE E, LEAVENWORTH, KS 66048-2822
(913) 682-9030
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
04-16539
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100084540A
KS MEDICAL ASSISTANCE PROGRAM
KS
05
—
2021825601
—
KS
Enumeration date
05/18/2009
Last updated
05/18/2009
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