Provider Demographics
NPI:1417940503
Name:MAULIK, DEV (MD PHD)
Entity Type:Individual
Prefix:
First Name:DEV
Middle Name:
Last Name:MAULIK
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:DEV
Other - Middle Name:
Other - Last Name:MAULIK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD PHD
Mailing Address - Street 1:2310 HOLMES ST STE 800
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2602
Mailing Address - Country:US
Mailing Address - Phone:816-404-8188
Mailing Address - Fax:
Practice Address - Street 1:2301 HOLMES ST
Practice Address - Street 2:DEPT OB GYN
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2640
Practice Address - Country:US
Practice Address - Phone:816-404-4966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-34690207V00000X, 207VM0101X
NY128865207V00000X, 207VM0101X, 207VM0101X
MOR8E04207VM0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal Medicine
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1417940503Medicaid
NY00480231Medicaid
C52261Medicare UPIN
MO1417940503Medicaid