Provider Demographics
NPI:1811939549
Name:ANIL V GOSALIA, MD, PA
Entity type:Organization
Organization Name:ANIL V GOSALIA, MD, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANIL
Authorized Official - Middle Name:V
Authorized Official - Last Name:GOSALIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-281-2605
Mailing Address - Street 1:PO BOX 879985
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64187-0001
Mailing Address - Country:US
Mailing Address - Phone:913-248-9693
Mailing Address - Fax:913-248-9383
Practice Address - Street 1:1610 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66102-2842
Practice Address - Country:US
Practice Address - Phone:913-281-2605
Practice Address - Fax:913-281-0087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-16677207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS8340000Medicare ID - Type Unspecified