Provider Demographics
NPI:1851396071
Name:TATPATI, ABRAHAM D (MD)
Entity Type:Individual
Prefix:DR
First Name:ABRAHAM
Middle Name:D
Last Name:TATPATI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1515 S CLIFTON AVE STE 205
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-2958
Mailing Address - Country:US
Mailing Address - Phone:316-689-6803
Mailing Address - Fax:316-689-0818
Practice Address - Street 1:1515 S CLIFTON AVE STE 205
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-2954
Practice Address - Country:US
Practice Address - Phone:316-689-6803
Practice Address - Fax:316-689-0818
Is Sole Proprietor?:No
Enumeration Date:2005-06-15
Last Update Date:2013-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS0429780207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS103023Medicare ID - Type Unspecified
KSH86353Medicare UPIN