Provider Demographics
NPI:1073964524
Name:CHATURVEDI, GAURAV
Entity Type:Individual
Prefix:
First Name:GAURAV
Middle Name:
Last Name:CHATURVEDI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6675 HOLMES RD
Mailing Address - Street 2:SUITE 360
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-1150
Mailing Address - Country:US
Mailing Address - Phone:816-276-7650
Mailing Address - Fax:816-276-7992
Practice Address - Street 1:6675 HOLMES RD
Practice Address - Street 2:SUITE 360
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64131-1150
Practice Address - Country:US
Practice Address - Phone:816-276-7650
Practice Address - Fax:816-276-7992
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016021980207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine