Organization
MIDWEST IDKC LLC
Active
Other names
MIDWEST IDKC LLC
Organization subpart
No
Provider details
NPI number
Authorized official
ATUL GUPTA M.D. (PRESIDENT)
(913) 274-1573
Entity
Organization
Contact information
Practice address
205 NW R D MIZE RD STE 105, BLUE SPRINGS, MO 64014-2519
(913) 274-1573
(763) 294-8335
Mailing address
PO BOX 8031, PRAIRIE VILLAGE, KS 66208-0031
(913) 274-1573
(763) 294-8335
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Enumeration date
08/19/2022
Last updated
09/02/2025
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