Provider Demographics
NPI:1710542923
Name:EJAZ, AIN UL (MBBS, MD)
Entity Type:Individual
Prefix:
First Name:AIN
Middle Name:UL
Last Name:EJAZ
Suffix:
Gender:F
Credentials:MBBS, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4330 WORNALL RD STE 65
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-3201
Mailing Address - Country:US
Mailing Address - Phone:816-932-6100
Mailing Address - Fax:816-932-9002
Practice Address - Street 1:4330 WORNALL RD STE 65
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3201
Practice Address - Country:US
Practice Address - Phone:816-932-6100
Practice Address - Fax:816-932-9002
Is Sole Proprietor?:No
Enumeration Date:2019-05-02
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MO2019017277207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program