Provider Demographics
NPI:1275945073
Name:KONDA, MONOJ KUMAR (MD)
Entity type:Individual
Prefix:MR
First Name:MONOJ
Middle Name:KUMAR
Last Name:KONDA
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 1:2750 CLAY EDWARDS DR STE 200A
Mailing Address - Street 2:
Mailing Address - City:NORTH KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64116-3277
Mailing Address - Country:US
Mailing Address - Phone:877-840-6992
Mailing Address - Fax:913-495-3712
Practice Address - Street 1:2800 CLAY EDWARDS DR
Practice Address - Street 2:
Practice Address - City:NORTH KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64116-3220
Practice Address - Country:US
Practice Address - Phone:877-840-6992
Practice Address - Fax:913-495-3712
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2024-09-13
Deactivation Date:2015-01-07
Deactivation Code:
Reactivation Date:2015-01-26
Provider Licenses
StateLicense IDTaxonomies
SD11846208M00000X
MO2017022830208M00000X, 207R00000X
MI4301105230207R00000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program