Provider Demographics
NPI:1689682676
Name:KHARE, PRATIBHA (MD)
Entity Type:Individual
Prefix:MRS
First Name:PRATIBHA
Middle Name:
Last Name:KHARE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:PRATIBHA
Other - Middle Name:
Other - Last Name:SHRIVASTAVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:11111 W 121 TERRACE
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1945
Mailing Address - Country:US
Mailing Address - Phone:913-897-4082
Mailing Address - Fax:913-661-9577
Practice Address - Street 1:11413 ASH ST
Practice Address - Street 2:LEAWOOD SURGERY CENTER
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211
Practice Address - Country:US
Practice Address - Phone:913-661-9977
Practice Address - Fax:913-661-9577
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0417737207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
C52247Medicare UPIN
KSK414200Medicare ID - Type Unspecified