Provider Demographics
NPI:1699180844
Name:AKELLA, PHANI (MD)
Entity type:Individual
Prefix:
First Name:PHANI
Middle Name:
Last Name:AKELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3901 RAINBOW BLVD # MS 1028
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66160-8500
Mailing Address - Country:US
Mailing Address - Phone:913-588-6035
Mailing Address - Fax:913-945-6916
Practice Address - Street 1:3901 RAINBOW BLVD STE 2
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66160-3604
Practice Address - Country:US
Practice Address - Phone:913-588-6035
Practice Address - Fax:810-342-5810
Is Sole Proprietor?:No
Enumeration Date:2014-06-26
Last Update Date:2024-07-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301104563207R00000X
KS94-11686207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine