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BERHANE GEBREHANNES SOLOMON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4401 WORNALL RD, KANSAS CITY, MO 64111-3220
(816) 932-0340
(816) 932-3148
Mailing address
901 E 104TH ST, KANSAS CITY, MO 64131-4517
(816) 502-8752
(816) 932-9670

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2011019882
MO
207R00000X
Internal Medicine Physician
9407056
KS
208M00000X
Hospitalist Physician
Primary
2011019882
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1104088947
TRICARE
MO
05
1104088947
MO
05
200743090A
KS
01
46273011
BCBSKC
MO
01
P00991402
RR MEDICARE
MO
Enumeration date
07/01/2008
Last updated
12/27/2016
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