Organization
FAMILY MEDCENTERS, P.A.
Active
Other names
FMC Diagnostic Center
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID WAYNE NIEDEREE M.D. (PRESIDENT)
(316) 788-6963
Entity
Organization
Contact information
Practice address
1101 N ROCK RD, DERBY, KS 67037-3735
(316) 788-1134
(316) 788-5373
Mailing address
1101 N ROCK RD, DERBY, KS 67037-3735
(316) 788-1134
(316) 788-5373
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110528
BCBS OF KANSAS
KS
Enumeration date
06/25/2007
Last updated
08/22/2020
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