Individual
LOREN D BERENBOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4000 CAMBRIDGE ST STE G600, KANSAS CITY, KS 66160-0001
(913) 588-9600
(913) 588-9770
Mailing address
4000 CAMBRIDGE ST STE G600, KANSAS CITY, KS 66160-8501
(913) 588-9600
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
04-19762
KS
207RC0000X
Cardiovascular Disease Physician
R8581
MO
207RC0001X
Clinical Cardiac Electrophysiology Physician
Primary
04-19762
KS
207RC0001X
Clinical Cardiac Electrophysiology Physician
R8581
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051552
BCBS KS
KS
05
—
100202580A
—
KS
05
—
100202580B
—
KS
01
—
10337013
BCBS KC
—
05
—
202205407
—
MO
Enumeration date
07/22/2006
Last updated
12/05/2018
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