Provider Demographics
NPI:1952797805
Name:UDDIN, ASIF A (MD)
Entity type:Individual
Prefix:DR
First Name:ASIF
Middle Name:A
Last Name:UDDIN
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 1:851 NW 45TH ST STE 105
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-4613
Mailing Address - Country:US
Mailing Address - Phone:816-708-0508
Mailing Address - Fax:816-631-0118
Practice Address - Street 1:851 NW 45TH ST # TE105
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-4628
Practice Address - Country:US
Practice Address - Phone:816-708-0508
Practice Address - Fax:816-631-0118
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0440938207R00000X, 2084P0800X
MO2020040266207R00000X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine