Provider Demographics
NPI:1861649303
Name:ASHFAQ, KASHIF (MD)
Entity Type:Individual
Prefix:DR
First Name:KASHIF
Middle Name:
Last Name:ASHFAQ
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 1:1303 UNIVERSITY DR
Mailing Address - Street 2:
Mailing Address - City:DODGE CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67801-2952
Mailing Address - Country:US
Mailing Address - Phone:316-243-0672
Mailing Address - Fax:844-220-3758
Practice Address - Street 1:2200 SUMMERLON CIR STE B
Practice Address - Street 2:
Practice Address - City:DODGE CITY
Practice Address - State:KS
Practice Address - Zip Code:67801-2905
Practice Address - Country:US
Practice Address - Phone:162-430-6723
Practice Address - Fax:844-220-3758
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP67001174400000X
TXBP10040662207XS0114X
MI4301096032207XX0005X
KSK-04-36058207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No174400000XOther Service ProvidersSpecialist
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine