Provider Demographics
NPI:1093878928
Name:WADOOD, UMAR (MD)
Entity type:Individual
Prefix:DR
First Name:UMAR
Middle Name:
Last Name:WADOOD
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 1:8340 MISSION RD
Mailing Address - Street 2:STE 210
Mailing Address - City:PRAIRIE VILAGE
Mailing Address - State:KS
Mailing Address - Zip Code:66206
Mailing Address - Country:US
Mailing Address - Phone:913-642-0100
Mailing Address - Fax:913-642-0176
Practice Address - Street 1:8340 MISSION RD
Practice Address - Street 2:STE 210
Practice Address - City:PRAIRIE VILAGE
Practice Address - State:KS
Practice Address - Zip Code:66206
Practice Address - Country:US
Practice Address - Phone:913-642-0100
Practice Address - Fax:913-642-0176
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-19
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS4238982084P0800X
MO1005652084P0800X
KS53810801212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
19291071OtherBCBS OF KANSAS CITY
KS100145630DMedicaid
MO206649626Medicaid