Provider Demographics
NPI:1407802895
Name:SHWAIKI, ALI (MD)
Entity Type:Individual
Prefix:
First Name:ALI
Middle Name:
Last Name:SHWAIKI
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 1:9301 W 74TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:MERRIAM
Mailing Address - State:KS
Mailing Address - Zip Code:66204-2217
Mailing Address - Country:US
Mailing Address - Phone:913-632-9100
Mailing Address - Fax:913-632-9159
Practice Address - Street 1:9301 W 74TH ST STE 100
Practice Address - Street 2:
Practice Address - City:MERRIAM
Practice Address - State:KS
Practice Address - Zip Code:66204-2217
Practice Address - Country:US
Practice Address - Phone:913-632-9100
Practice Address - Fax:913-632-9159
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2022-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2004017398207RX0202X
KS31661207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
77528OtherHEALTHCARE USA
33973013OtherBCBS OF KC
7623568OtherAETNA
P00253441OtherRAILROAD MEDICARE
MO200506004Medicaid
2410698OtherUHC
L76D393Medicare PIN
MO200506004Medicaid
MOW19000165Medicare PIN
KSKA2493004Medicare PIN