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Individual

DR. MICHAEL J WAXMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6420 PROSPECT AVENUE, T303, KANSAS CITY, MO 64132
(816) 333-1919
(816) 361-1930
Mailing address
6420 PROSPECT AVENUE, T303, KANSAS CITY, MO 64132
(816) 333-1919
(816) 361-1930

Taxonomy

Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
0417387
KS
207RP1001X
Pulmonary Disease Physician
Primary
R1E71
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100206310 B
KS
05
100206310 C
KS
05
100206310A
KS
05
100206310D
KS
05
202423208
MO
Enumeration date
05/02/2006
Last updated
09/11/2013
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