Provider Demographics
NPI:1215973102
Name:KHUMRI, TAIYEB M (MD)
Entity type:Individual
Prefix:
First Name:TAIYEB
Middle Name:M
Last Name:KHUMRI
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:MAILSTOP 400S
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131
Mailing Address - Country:US
Mailing Address - Phone:816-502-7117
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:4330 WORNALL RD
Practice Address - Street 2:SUITE 2000
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111
Practice Address - Country:US
Practice Address - Phone:816-931-1883
Practice Address - Fax:816-756-3645
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2020-08-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO2005019478207RC0000X, 207RA0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO207427709Medicaid
MOMA2492056Medicare PIN
MOF06E065Medicare ID - Type Unspecified
KSKA2004055Medicare PIN
KSKA1724055Medicare PIN
MO207427709Medicaid
MOMA2491056Medicare PIN