Individual
DR. TASANAPORN PITIYANUVATH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2340 E MEYER BLVD STE 200, KANSAS CITY, MO 64132-1121
(816) 753-5144
(816) 777-2796
Mailing address
2340 E MEYER BLVD STE 200, KANSAS CITY, MO 64132-1121
(816) 753-5144
(816) 777-2796
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
33971
MO
208000000X
Pediatrics Physician
Primary
33971
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201583416
—
MO
Enumeration date
07/03/2006
Last updated
07/26/2021
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