Provider Demographics
NPI:1780689885
Name:GEHA, DANIEL J (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:J
Last Name:GEHA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8800 STATE LINE RD
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66206-1553
Mailing Address - Country:US
Mailing Address - Phone:913-383-9099
Mailing Address - Fax:913-383-9611
Practice Address - Street 1:8800 STATE LINE RD
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66206-1553
Practice Address - Country:US
Practice Address - Phone:913-383-9099
Practice Address - Fax:913-383-9611
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0425005174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100296670AMedicaid
MO0009375OtherMEDICARE ID
MO208897801Medicaid
MO0009375OtherMEDICARE ID
F44816Medicare UPIN