Organization
EHTISHAM NEUROVASCULAR INSTITUTE & AESTHESTICS P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AS'AD EHTISHAM MD (OWNER)
(316) 303-2153
Entity
Organization
Contact information
Practice address
3223 N WEBB RD, SUITE 5, WICHITA, KS 67226-8175
(316) 303-2153
(877) 381-0101
Mailing address
6120 SHADYBROOK ST, WICHITA, KS 67208-1862
(316) 633-4413
(877) 381-0101
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
04-31300
KS
2084V0102X
Vascular Neurology Physician
Primary
04-31300
KS
Other
Enumeration date
11/29/2012
Last updated
11/29/2012
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