Provider Demographics
NPI:1508035163
Name:CHHATRIWALLA, ADNAN K (MD)
Entity Type:Individual
Prefix:
First Name:ADNAN
Middle Name:K
Last Name:CHHATRIWALLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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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:816-502-7117
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:4330 WORNALL RD
Practice Address - Street 2:SUITE 2000
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-5939
Practice Address - Country:US
Practice Address - Phone:816-931-1883
Practice Address - Fax:816-756-3645
Is Sole Proprietor?:No
Enumeration Date:2008-02-27
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2009005683207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKA1021035OtherMEDICARE - CUSHING
KS200604060BMedicaid
KSP00842596OtherRAILROAD MEDICARE
MOP00842656OtherRAILROAD MEDICARE
MO776A00003OtherMEDICARE - TRENTON
KS200604060EMedicaid
KS200604060COtherMEDICAID - CUSHING
KS200604060CMedicaid
MO200604060AMedicaid
KS200604060DMedicaid
MOP00842656OtherRAILROAD MEDICARE
MO200604060AMedicaid
KSKA1021035OtherMEDICARE - CUSHING
KS200604060COtherMEDICAID - CUSHING