Provider Demographics
NPI:1164835880
Name:ABRAHAM, ASHRITA (MD)
Entity Type:Individual
Prefix:
First Name:ASHRITA
Middle Name:
Last Name:ABRAHAM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 E 104TH ST # MS 400
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:816-756-2255
Mailing Address - Fax:816-931-4080
Practice Address - Street 1:4321 WASHINGTON ST STE 6000
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5930
Practice Address - Country:US
Practice Address - Phone:816-756-2255
Practice Address - Fax:816-931-4080
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2022-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA323445207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program