Provider Demographics
NPI:1841270600
Name:AZNAUROVA, LOLITTA EDUARDOVNA (MD)
Entity type:Individual
Prefix:
First Name:LOLITTA
Middle Name:EDUARDOVNA
Last Name:AZNAUROVA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LOLITTA
Other - Middle Name:EDUARDOVNA
Other - Last Name:SAAKOVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8900 STATE LINE RD
Mailing Address - Street 2:STE 380
Mailing Address - City:LEAWOOD
Mailing Address - State:KS
Mailing Address - Zip Code:66206
Mailing Address - Country:US
Mailing Address - Phone:913-385-7252
Mailing Address - Fax:913-385-2412
Practice Address - Street 1:8900 STATE LINE RD
Practice Address - Street 2:STE 380
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66206
Practice Address - Country:US
Practice Address - Phone:913-385-7252
Practice Address - Fax:913-385-2412
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2012-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04274222084P0800X
MO20001439192084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
26382016OtherBCBS OF KC
057814Medicare ID - Type Unspecified
A918750AMedicare ID - Type Unspecified
A918750BMedicare ID - Type Unspecified
MOA91000007Medicare PIN
G86703Medicare UPIN