Provider Demographics
NPI:1457300287
Name:KHANNA, RAMESH (MD)
Entity Type:Individual
Prefix:
First Name:RAMESH
Middle Name:
Last Name:KHANNA
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:PO BOX 843966
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64184-3966
Mailing Address - Country:US
Mailing Address - Phone:573-884-3300
Mailing Address - Fax:573-884-0943
Practice Address - Street 1:1020 HITT ST
Practice Address - Street 2:DC056.20
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65212-6521
Practice Address - Country:US
Practice Address - Phone:573-882-8788
Practice Address - Fax:573-882-3131
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR4D01207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO25127OtherBLUE SHIELD/BLUE CHOICE
MO102520OtherHEALTHLINK
KS2086333301OtherKANSAS MEDICAID
MO3104004OtherUNITED HEALTHCARE
MO201870318Medicaid
MO201870318Medicaid
MO340007977Medicare PIN
MO102520OtherHEALTHLINK
MO008011442Medicare PIN
MOA13020Medicare UPIN