Eustaquio O Abay II, M.D.

Individual provider Active NPI Neurological Surgery Physician · Wichita, KS

NPI 1013949338 · NPPES record last updated Apr 9, 2012

Key facts

NPI
1013949338
Entity type
Individual (NPI type 1)
Primary specialty
Neurological Surgery Physician 207T00000X
License
04-21083 (KS)
Practice address
3305 E Douglas Ave
Suite 101
Wichita, KS 67218-1037
Phone
(316) 425-0005
Fax
(316) 425-0007
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-21083KSMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Abay Neuroscience Center LLC Specialist Past
since Jun 1, 2005
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 0421083 KS
Neurological Surgery Physician 207T00000X 04-21083 KS Yes

Addresses

Primary practice location

3305 E Douglas Ave
Suite 101
Wichita, KS 67218-1037

Mailing address

3305 E Douglas Ave
Suite 101
Wichita, KS 67218-1037
Phone (316) 425-0005

Other identifiers

IdentifierTypeStateIssuer
100204380CMedicaidKS

Other providers in Wichita, KS

All providers in Wichita, KS · Neurological Surgery Physician in Kansas

Sources for this page

Verify at the official NPI Registry.