Provider Demographics
NPI:1336249200
Name:OBI, VANAJA R (MD)
Entity Type:Individual
Prefix:
First Name:VANAJA
Middle Name:R
Last Name:OBI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VANAJA
Other - Middle Name:R
Other - Last Name:KAMISETTY-OBILISETTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:501 S SANTA FE AVE
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4189
Mailing Address - Country:US
Mailing Address - Phone:785-825-2273
Mailing Address - Fax:785-825-2275
Practice Address - Street 1:501 S SANTA FE AVE
Practice Address - Street 2:SUITE 100
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4189
Practice Address - Country:US
Practice Address - Phone:785-825-2273
Practice Address - Fax:785-825-2275
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-24593208000000X, 207RE0101X, 2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
No2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100147460BCMedicaid
E62128Medicare UPIN
KS110116033Medicare PIN
KS100147460BCMedicaid