Provider Demographics
NPI:1356795868
Name:SANKOORIKAL, MARK GEORGE (MD)
Entity type:Individual
Prefix:
First Name:MARK
Middle Name:GEORGE
Last Name:SANKOORIKAL
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 1:10601 QUIVIRA RD STE 200
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66215-2320
Mailing Address - Country:US
Mailing Address - Phone:913-541-3340
Mailing Address - Fax:
Practice Address - Street 1:10601 QUIVIRA RD STE 200
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66215-2320
Practice Address - Country:US
Practice Address - Phone:913-541-3340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-20
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-42097207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine