Provider Demographics
NPI:1861481665
Name:ARAKELOV, ALEXANDR V (MD)
Entity Type:Individual
Prefix:MR
First Name:ALEXANDR
Middle Name:V
Last Name:ARAKELOV
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 1:2340 E MEYER BLVD, BLDG 2
Mailing Address - Street 2:SUITE 480
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64132
Mailing Address - Country:US
Mailing Address - Phone:816-276-1700
Mailing Address - Fax:816-276-1703
Practice Address - Street 1:2340 E MEYER BLVD, BLDG 2
Practice Address - Street 2:SUITE 480
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64132
Practice Address - Country:US
Practice Address - Phone:816-276-1700
Practice Address - Fax:816-276-1703
Is Sole Proprietor?:No
Enumeration Date:2005-10-14
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000156762207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205112907Medicaid
KS100399730AMedicaid
H17766Medicare UPIN
373A436Medicare ID - Type Unspecified