Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 036-111255 | IL |
N | 208600000X | Surgeon | 036-111255 | IL |
N | 208200000X | Surgeon | T 00734 | KS |
N | 208600000X | Surgeon | T 00734 | KS |
N | 2086S0129X | Vascular Surgeon | 036-111255 | IL |
Y | 2086S0129X | Vascular Surgeon | 2016004892 | MO |
N | 2086S0129X | Vascular Surgeon | T 00734 | KS |
NPI | 1033141635 |
---|---|
Provider Name | Karthik Vamanan |
First Address | Kansas City, MO 64111-5943 |
Second Address | Kansas City, MO 64111-5943 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 31/07/2020 |