Organization
MID-AMERICA POLYCLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SRINIVAS NALAMACHU MD (PRESIDENT)
(913) 599-2440
Entity
Organization
Contact information
Practice address
7100 COLLEGE BLVD, OVERLAND PARK, KS 66210
(913) 599-2440
(913) 599-5252
Mailing address
7100 COLLEGE BLVD, OVERLAND PARK, KS 66210
(913) 599-2440
(913) 599-5252
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21532015
BLUE SHIELD KANSAS CITY
MO
Enumeration date
03/21/2006
Last updated
02/11/2019
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