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Organization
MARIA MEDICAL SERVICES LLC
Active
Organization
MARIA MEDICAL SERVICES LLC
Active
Other names
Med-Ped Clinic of Wichita
Organization subpart
No
Provider details
NPI number
Authorized official
MANSOOR TAHIR PA (ADMINISTRATOR)
(316) 440-2712
Entity
Organization
Contact information
Practice address
9415 E HARRY ST STE 202, WICHITA, KS 67207-5076
(316) 691-0309
(316) 691-0881
Mailing address
9415 E HARRY ST STE 202, WICHITA, KS 67207-5076
(316) 691-0309
(316) 691-0881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
NULL
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
10/14/2015
Last updated
10/14/2015
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