Provider Demographics
NPI:1285681460
Name:ANANTH, SHEELA (MD)
Entity Type:Individual
Prefix:
First Name:SHEELA
Middle Name:
Last Name:ANANTH
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 1:2808 W 117TH ST
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-3030
Mailing Address - Country:US
Mailing Address - Phone:816-373-1142
Mailing Address - Fax:816-373-9222
Practice Address - Street 1:17500 MEDICAL CENTER PKWY
Practice Address - Street 2:SUITE 5
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-1823
Practice Address - Country:US
Practice Address - Phone:816-373-1142
Practice Address - Fax:816-373-9222
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR7P07208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOH00364Medicare UPIN