Provider Demographics
NPI:1255300133
Name:EKRAM, RAONAK (MD)
Entity Type:Individual
Prefix:DR
First Name:RAONAK
Middle Name:
Last Name:EKRAM
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
Mailing Address - Street 2:MAILSTOP 400S
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131
Mailing Address - Country:US
Mailing Address - Phone:816-251-5600
Mailing Address - Fax:
Practice Address - Street 1:2529 GLENN HENDREN DR STE G30
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-9610
Practice Address - Country:US
Practice Address - Phone:816-251-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-31400207RX0202X
MO2003010143207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1255300133OtherAETNA
MO1255300133OtherCOVENTRY HEALTH CARE NATIONAL NET
36105014OtherBC/BS KANSAS CITY
KS200354280AMedicaid
MOCN6539OtherPALMETTO GBA - RR MEDICARE PART B
MO1255300133OtherHEALTHLINK PPO
MO1255300133OtherMISSOURI CARE
MO1255300133OtherHEALTH CARE USA
MO1255300133OtherMERCY HEALTH CARE PLANS
MO1255300133OtherMEDICAID OF MISSOURI
7467204OtherAETNA
MO123240007OtherMEDICARE OF MISSOURI
MO1255300133OtherHEALTHLINK HMO
MO1255300133OtherGHP
MO1255300133OtherGREAT WEST
MO1255300133OtherCIGNA
MO1255300133OtherUNITED HEALTH CARE OF ALLSTATE
105085OtherBC/BS OF KANSAS
MO1255300133OtherBLUE CROSS AND BLUE SHIELD OF MISSOURI
928179OtherFIRST GUARD
MO1255300133OtherMOLINA HEALTH CARE OF MISSOURI
MO1255300133OtherTRICARE WEST REGIONAL
MO1255300133OtherCIGNA
928179OtherFIRST GUARD