Provider Demographics
NPI:1457562407
Name:DHAKHWA, SAURAV (MD)
Entity Type:Individual
Prefix:
First Name:SAURAV
Middle Name:
Last Name:DHAKHWA
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 1:250 NE MULBERRY
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LEE'S SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64086-4533
Mailing Address - Country:US
Mailing Address - Phone:816-389-4130
Mailing Address - Fax:816-389-4140
Practice Address - Street 1:250 NE MULBERRY
Practice Address - Street 2:SUITE 202
Practice Address - City:LEE'S SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64086-4533
Practice Address - Country:US
Practice Address - Phone:816-389-4130
Practice Address - Fax:816-389-4140
Is Sole Proprietor?:No
Enumeration Date:2007-05-24
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301087456207L00000X
MO2010034265207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology