Provider Demographics
NPI:1699878504
Name:BAJRACHARYA, HIMAL B (MD)
Entity type:Individual
Prefix:
First Name:HIMAL
Middle Name:B
Last Name:BAJRACHARYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4601 W 109TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66211-1313
Mailing Address - Country:US
Mailing Address - Phone:913-942-0540
Mailing Address - Fax:630-528-9589
Practice Address - Street 1:4601 W 109TH ST STE 100
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66211-1313
Practice Address - Country:US
Practice Address - Phone:913-942-0540
Practice Address - Fax:630-528-9589
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2019-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2009021564207RI0200X
KS04-28743207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO205878101Medicaid
MO31421018OtherBCBS KC
KS100420660AMedicaid
MO278F00004Medicare Oscar/Certification
MO31421018OtherBCBS KC
MO278A00003Medicare Oscar/Certification