Provider Demographics
NPI:1386634673
Name:KHILNANI, PRAVEEN KUMAR (MD)
Entity Type:Individual
Prefix:DR
First Name:PRAVEEN
Middle Name:KUMAR
Last Name:KHILNANI
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:B 42
Mailing Address - Street 2:PANCHSHEEL ENCLAVE
Mailing Address - City:NEW DELHI
Mailing Address - State:DELHI
Mailing Address - Zip Code:110017
Mailing Address - Country:IN
Mailing Address - Phone:01191981-015-9466
Mailing Address - Fax:
Practice Address - Street 1:929 N SAINT FRANCIS ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67214-3821
Practice Address - Country:US
Practice Address - Phone:316-268-5794
Practice Address - Fax:316-291-7921
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-299882080P0203X
FLME759652080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL279183800Medicaid
KS100447880AMedicaid
KS102647Medicare ID - Type Unspecified
BW807ZMedicare PIN
FL279183800Medicaid
D87793Medicare UPIN