Individual
DR. SRINIVASA R KAKUMANU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 676-2000
(913) 789-3190
Mailing address
PO BOX 931288, KANSAS CITY, MO 64193-0001
(913) 789-4155
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
04-31418
KS
208M00000X
Hospitalist Physician
04-31418
KS
208M00000X
Hospitalist Physician
Primary
2013002440
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200355490A
—
KS
01
—
36056012
BLUE CROSS
KS
01
—
927945
FIRSTGUARD
KS
Enumeration date
09/29/2006
Last updated
05/01/2020
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