Individual
DR. MICHAEL GABRIEL AZZAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5200 W 94TH TER STE 113, PRAIRIE VILLAGE, KS 66207-2522
(913) 906-8640
(913) 906-8682
Mailing address
5200 W 94TH TER STE 113, PRAIRIE VILLAGE, KS 66207-2522
(913) 906-8640
(913) 906-8682
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
04-41486
KS
207X00000X
Orthopaedic Surgery Physician
2016016714
MO
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
04-41486
KS
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
2016016714
MO
Other
Enumeration date
06/18/2010
Last updated
06/18/2021
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