Provider Demographics
NPI:1477608784
Name:BAVISHI, SAROJ A (MD)
Entity type:Individual
Prefix:
First Name:SAROJ
Middle Name:A
Last Name:BAVISHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20375 W 151ST ST
Mailing Address - Street 2:STE 407
Mailing Address - City:OLATHE
Mailing Address - State:KS
Mailing Address - Zip Code:66061-7209
Mailing Address - Country:US
Mailing Address - Phone:913-897-9433
Mailing Address - Fax:
Practice Address - Street 1:20375 W 151ST ST
Practice Address - Street 2:SUITE 407
Practice Address - City:OLATHE
Practice Address - State:KS
Practice Address - Zip Code:66061-7218
Practice Address - Country:US
Practice Address - Phone:913-829-9100
Practice Address - Fax:913-829-9110
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2016-12-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSKS0418341207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS2050606101Medicaid
KS0006014Medicare ID - Type Unspecified
KSC50533Medicare UPIN