Provider Demographics
NPI:1689844664
Name:CHUDA, RAVINDRA REDDY (MD)
Entity Type:Individual
Prefix:DR
First Name:RAVINDRA
Middle Name:REDDY
Last Name:CHUDA
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 1:11300 CORPORATE AVE
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66219-1374
Mailing Address - Country:US
Mailing Address - Phone:913-574-2800
Mailing Address - Fax:913-574-2336
Practice Address - Street 1:4881 NE GOODVIEW CIR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-1996
Practice Address - Country:US
Practice Address - Phone:913-574-2350
Practice Address - Fax:913-574-2413
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2018-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0434712207RH0003X
MO2017016021207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1689844664Medicaid
KS200680430CMedicaid
FL001941100Medicaid