Individual
DR. KISHAN YALAVARTHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4000 CAMBRIDGE ST, KANSAS CITY, KS 66160-3417
(913) 588-1235
Mailing address
1715 DEER TRACKS TRL, SUITE 130, SAINT LOUIS, MO 63131-1839
(314) 821-5600
(314) 821-2180
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
04-29675
KS
2085R0202X
Diagnostic Radiology Physician
2002010077
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
207309501
—
MO
Enumeration date
03/01/2007
Last updated
07/05/2024
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