Organization
SERAFINI MEDICAL, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GHAISON F. SERAFINI DO (DR./D.O./OWNER)
(816) 224-3155
Entity
Organization
Contact information
Practice address
1509 NW MOCK AVE, BLUE SPRINGS, MO 64015-3096
(816) 224-3155
(816) 224-3185
Mailing address
1509 NW MOCK AVE, BLUE SPRINGS, MO 64015-3096
(816) 224-3155
(816) 224-3185
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
2013035498
MO
207Q00000X
Family Medicine Physician
Primary
2013035498
MO
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
2013035498
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26D2079913
CLIA
MO
01
—
MA5221
MEDICARE PTAN - INDIVIDUAL
MO
01
—
MA5221001
MEDICARE PTAN - GROUP
MO
Enumeration date
08/25/2014
Last updated
07/10/2018
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