Provider Demographics
NPI:1295942472
Name:SAGDUYU HEALING CENTER, LLC
Entity type:Organization
Organization Name:SAGDUYU HEALING CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEMAL
Authorized Official - Middle Name:
Authorized Official - Last Name:SAGDUYU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:913-322-6606
Mailing Address - Street 1:8801 W 148TH TER
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66221-9359
Mailing Address - Country:US
Mailing Address - Phone:913-322-6606
Mailing Address - Fax:913-322-6606
Practice Address - Street 1:8631 W 150TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223-2974
Practice Address - Country:US
Practice Address - Phone:913-322-6606
Practice Address - Fax:913-322-6606
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04255372084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0009493Medicare ID - Type Unspecified
F62218Medicare UPIN