Provider Demographics
NPI:1861598344
Name:GERJARUSAK, PRAPAS (MD)
Entity type:Individual
Prefix:
First Name:PRAPAS
Middle Name:
Last Name:GERJARUSAK
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 1:11709 NORWOOD DR
Mailing Address - Street 2:
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66211-3003
Mailing Address - Country:US
Mailing Address - Phone:913-262-0344
Mailing Address - Fax:913-262-2607
Practice Address - Street 1:11709 NORWOOD DR
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66211-3003
Practice Address - Country:US
Practice Address - Phone:913-262-0344
Practice Address - Fax:913-262-2607
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS16121207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSA244318Medicare PIN