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Individual

DR. KIMBERLY DAWN PONNURU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
7450 KESSLER ST, STE 201, MERRIAM, KS 66204
(913) 632-9200
(913) 632-9209
Mailing address
7450 KESSLER ST, STE 201, MERRIAM, KS 66204
(913) 632-9200
(913) 632-9209

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0429857
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0429857
KS STATE BOARD OF HEALING
KS
Enumeration date
09/29/2006
Last updated
11/05/2019
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