Provider Demographics
NPI:1801847439
Name:DESILVA, MAHASEN T (MD)
Entity Type:Individual
Prefix:DR
First Name:MAHASEN
Middle Name:T
Last Name:DESILVA
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 1:3707 SW 6TH AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-2084
Mailing Address - Country:US
Mailing Address - Phone:785-270-4600
Mailing Address - Fax:785-270-4628
Practice Address - Street 1:835 SW WESTERN AVE
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-1446
Practice Address - Country:US
Practice Address - Phone:785-270-4600
Practice Address - Fax:785-270-4601
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-16
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04166552084P0800X
KS04-166552084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100119740BMedicaid
D05363Medicare UPIN
KS100119740BMedicaid