Provider Demographics
NPI:1780640276
Name:DANUSHKODI, KALA (MD)
Entity Type:Individual
Prefix:DR
First Name:KALA
Middle Name:
Last Name:DANUSHKODI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2700 CLAY EDWARDS DR
Mailing Address - Street 2:SUITE 310
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3251
Mailing Address - Country:US
Mailing Address - Phone:816-455-1313
Mailing Address - Fax:816-455-1314
Practice Address - Street 1:2700 CLAY EDWARDS DR
Practice Address - Street 2:SUITE 310
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3251
Practice Address - Country:US
Practice Address - Phone:816-455-1313
Practice Address - Fax:816-455-1314
Is Sole Proprietor?:No
Enumeration Date:2006-04-24
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2002013878208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205913817Medicaid
MOH63461Medicare UPIN
MO205913817Medicaid