Sanjaya P Perera
Individual provider Active NPI Driver · Andover, KS
NPI 1972078673 · NPPES record last updated Oct 9, 2018
Key facts
- NPI
- 1972078673
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- K02000264 (KS)
- Practice address
- 649 S Cherrywood Cir
Andover, KS 67002-8948 - Phone
- (316) 708-1950
- NPI assigned
- Oct 9, 2018
- Sex
- Male
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| K02000264 | KS | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | K02000264 | KS | Yes |
Addresses
Primary practice location
649 S Cherrywood Cir
Andover, KS 67002-8948
Mailing address
649 S Cherrywood Cir
Andover, KS 67002-8948
Phone (316) 708-1950
Other providers in Andover, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 9, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.