Provider Demographics
NPI:1982129805
Name:MISHRA, ABHAY (MD)
Entity Type:Individual
Prefix:
First Name:ABHAY
Middle Name:
Last Name:MISHRA
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 1:3901 RAINBOW BLVD HOSPITAL MEDICINE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8500
Mailing Address - Country:US
Mailing Address - Phone:913-588-1422
Mailing Address - Fax:913-588-3877
Practice Address - Street 1:3901 RAINBOW BOULEVARD HOSPITAL MEDICINE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-2017
Practice Address - Country:US
Practice Address - Phone:913-588-1422
Practice Address - Fax:913-588-3877
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017027308207RH0002X
MI4351045572207RN0300X
390200000X
KS04-47662208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program