Provider Demographics
NPI:1669115820
Name:KHAMUANI, MANOJ KUMAR (MD)
Entity type:Individual
Prefix:MR
First Name:MANOJ
Middle Name:KUMAR
Last Name:KHAMUANI
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 1:12140 NALL AVENUE, STE. 300
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66209
Mailing Address - Country:US
Mailing Address - Phone:832-604-0204
Mailing Address - Fax:
Practice Address - Street 1:12140 NALL AVENUE, STE. 300
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209
Practice Address - Country:US
Practice Address - Phone:832-604-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-15
Last Update Date:2023-01-19
Deactivation Date:2023-01-12
Deactivation Code:
Reactivation Date:2023-01-19
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program