Provider Demographics
NPI:1467421016
Name:TADROS, MAGDY MONIR (MD)
Entity Type:Individual
Prefix:
First Name:MAGDY
Middle Name:MONIR
Last Name:TADROS
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 25473
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66225-5473
Mailing Address - Country:US
Mailing Address - Phone:913-592-4560
Mailing Address - Fax:
Practice Address - Street 1:9318 W 146TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66221-2250
Practice Address - Country:US
Practice Address - Phone:913-685-4138
Practice Address - Fax:913-685-8140
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-16
Last Update Date:2019-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0425748207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100268170DMedicaid
F37571Medicare UPIN