Provider Demographics
NPI:1164493201
Name:AMIRANI, HOSSEIN (MD)
Entity Type:Individual
Prefix:
First Name:HOSSEIN
Middle Name:
Last Name:AMIRANI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 47212
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67201-7212
Mailing Address - Country:US
Mailing Address - Phone:316-616-3333
Mailing Address - Fax:316-616-0974
Practice Address - Street 1:925 N HILLSIDE ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3219
Practice Address - Country:US
Practice Address - Phone:316-616-3333
Practice Address - Fax:316-616-0974
Is Sole Proprietor?:No
Enumeration Date:2006-01-27
Last Update Date:2021-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0428505207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100351790DMedicaid
KS100351790DMedicaid
KS17D1048840OtherCLIA
KS105057Medicare PIN
F67243Medicare UPIN