Provider Demographics
NPI:1568574978
Name:KYASA, MOUHAMMED JAMEEL (MD)
Entity Type:Individual
Prefix:
First Name:MOUHAMMED
Middle Name:JAMEEL
Last Name:KYASA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9301 W 74TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE MISSION
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:SHAWNEE MISSION
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:2006-08-31
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KS04-34098207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology