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Organization
OBSTETRICS AND PEDIATRICS SUBSPECIALTY GROUP OF KANSAS AND MISSOURI PA
Active
Organization
OBSTETRICS AND PEDIATRICS SUBSPECIALTY GROUP OF KANSAS AND MISSOURI PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL D DWYER (ASSISTANT SECRETARY)
(954) 384-0175
Entity
Organization
Contact information
Practice address
4722 N 24TH ST STE 150, PHOENIX, AZ 85016-4860
(877) 885-0588
Mailing address
1301 CONCORD TER, SUNRISE, FL 33323-2843
(800) 243-3839
(844) 686-2961
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
NULL
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
207XP3100X
Pediatric Orthopaedic Surgery Physician
—
NULL
207XP3100X
Pediatric Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
NULL
208000000X
Pediatrics Physician
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
NULL
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
2080P0202X
Pediatric Cardiology Physician
—
NULL
2080P0202X
Pediatric Cardiology Physician
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
—
NULL
2080P0203X
Pediatric Critical Care Medicine Physician
—
—
2080P0206X
Pediatric Gastroenterology Physician
—
NULL
2080P0206X
Pediatric Gastroenterology Physician
—
—
2080P0208X
Pediatric Infectious Diseases Physician
—
NULL
2080P0208X
Pediatric Infectious Diseases Physician
—
—
2086S0120X
Pediatric Surgery Physician
—
NULL
2086S0120X
Pediatric Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100309390A
—
KS
05
—
100309390B
—
KS
05
—
162830002
—
AR
Enumeration date
07/26/2006
Last updated
10/23/2024
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