Provider Demographics
NPI:1942659529
Name:VENUGOPAL, ANAND (MD)
Entity Type:Individual
Prefix:
First Name:ANAND
Middle Name:
Last Name:VENUGOPAL
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 1:901 E 104TH ST
Mailing Address - Street 2:MAILSTOP 400S
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131
Mailing Address - Country:US
Mailing Address - Phone:913-491-9100
Mailing Address - Fax:
Practice Address - Street 1:12330 METCALF AVE STE 420
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1307
Practice Address - Country:US
Practice Address - Phone:913-491-9100
Practice Address - Fax:913-491-9135
Is Sole Proprietor?:No
Enumeration Date:2016-06-06
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022008557207RG0100X
MI4301109278390200000X
KS0445850207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program