Provider Demographics
NPI:1790718708
Name:GASLIGHTWALA, SHEREBANU F (MD)
Entity Type:Individual
Prefix:DR
First Name:SHEREBANU
Middle Name:F
Last Name:GASLIGHTWALA
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 1:9501 STATE AVE
Mailing Address - Street 2:SUITE #3
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66111-1872
Mailing Address - Country:US
Mailing Address - Phone:913-299-2229
Mailing Address - Fax:913-334-0664
Practice Address - Street 1:9501 STATE AVE
Practice Address - Street 2:SUITE #3
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66111-1872
Practice Address - Country:US
Practice Address - Phone:913-299-2229
Practice Address - Fax:913-334-0664
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0430251207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
H39993Medicare UPIN
328C965Medicare ID - Type Unspecified