Provider Demographics
NPI:1386819738
Name:SIRAJUDDIN, IRAM (MD)
Entity Type:Individual
Prefix:
First Name:IRAM
Middle Name:
Last Name:SIRAJUDDIN
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 1:3243 E MURDOCK ST
Mailing Address - Street 2:SUITE #500
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-3052
Mailing Address - Country:US
Mailing Address - Phone:316-962-2080
Mailing Address - Fax:316-962-2079
Practice Address - Street 1:3243 E MURDOCK ST
Practice Address - Street 2:SUITE #500
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-3052
Practice Address - Country:US
Practice Address - Phone:316-962-2080
Practice Address - Fax:316-962-2079
Is Sole Proprietor?:No
Enumeration Date:2008-04-28
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-346732080P0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0201XAllopathic & Osteopathic PhysiciansPediatricsPediatric Allergy/Immunology