# OBSTETRICS AND PEDIATRICS SUBSPECIALTY GROUP OF KANSAS AND MISSOURI PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225051618
- **Authorized official:** DR. MICHAEL D DWYER (ASSISTANT SECRETARY)
- **Authorized official phone:** (954) 384-0175

## Contact information

- **Practice address:** 4722 N 24TH ST STE 150, PHOENIX, AZ 85016-4860
- **Practice address phone:** (877) 885-0588
- **Mailing address:** 1301 CONCORD TER, SUNRISE, FL 33323-2843
- **Mailing address phone:** (800) 243-3839
- **Mailing address fax:** (844) 686-2961

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | NULL | Yes |
| 207VM0101X | Maternal & Fetal Medicine Physician | — | — | Yes |
| 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

- **Enumeration date:** 07/26/2006
- **Last updated:** 10/23/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100309390A | — | KS |
| 05 | — | 100309390B | — | KS |
| 05 | — | 162830002 | — | AR |