Organization
OBSTETRICS AND PEDIATRICS SUBSPECIALTY GROUP OF KANSAS AND MISSOURI PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL D DWYER (ASSISTANT SECRETARY)
(954) 384-0175
Entity
Organization
Contact information
Practice address
4722 N 24TH ST STE 150, PHOENIX, AZ 85016-4860
(877) 885-0588
Mailing address
1301 CONCORD TER, SUNRISE, FL 33323-2843
(800) 243-3839
(844) 686-2961
Taxonomy
Speciality
Code
Description
License number
State
207VM0101X
Maternal & Fetal Medicine Physician
Primary
—
—
207XP3100X
Pediatric Orthopaedic Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
2080P0006X
Developmental - Behavioral Pediatrics Physician
—
—
2080P0202X
Pediatric Cardiology Physician
—
—
2080P0203X
Pediatric Critical Care Medicine Physician
—
—
2080P0206X
Pediatric Gastroenterology Physician
—
—
2080P0208X
Pediatric Infectious Diseases Physician
—
—
2086S0120X
Pediatric Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100309390A
—
KS
05
—
100309390B
—
KS
05
—
162830002
—
AR
Enumeration date
07/26/2006
Last updated
10/23/2024
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us