Elizabeth Gontero Hudek, MD

Individual provider Active NPI Gynecology Physician · Fairway, KS

NPI 1134466444 · NPPES record last updated Jan 7, 2013

Key facts

NPI
1134466444
Entity type
Individual (NPI type 1)
Primary specialty
Gynecology Physician 207VG0400X
License
04-23546 (KS)
Practice address
5607 Canterbury Rd
Fairway, KS 66205-2620
Phone
(913) 645-5555
NPI assigned
Jan 7, 2013
Sex
Female
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
04-23546KSMDGynecology Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X 04-23546 KS Yes

Addresses

Primary practice location

5607 Canterbury Rd
Fairway, KS 66205-2620

Mailing address

5607 Canterbury Rd
Fairway, KS 66205-2620
Phone (913) 645-5555

Other providers in Fairway, KS

All providers in Fairway, KS · Gynecology Physician in Kansas

Sources for this page

Verify at the official NPI Registry.