Provider Demographics
NPI:1710202437
Name:UNIVERSITY OF KANSAS MEDICAL CENTER
Entity Type:Organization
Organization Name:UNIVERSITY OF KANSAS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHIQIANG
Authorized Official - Middle Name:
Authorized Official - Last Name:TIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-588-6777
Mailing Address - Street 1:3900 RAINBOW BLVD
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66103-2918
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3900 RAINBOW BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66103-2918
Practice Address - Country:US
Practice Address - Phone:913-588-6777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-06
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT195960282N00000X
KS94-07405282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital