Individual
NICHOLAS WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2525 GLENN HENDREN DR, LIBERTY, MO 64068
(816) 792-7000
Mailing address
2609 GLENN HENDREN DR, LIBERTY, MO 64068-3313
(816) 407-4555
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2015018604
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58164011
BCBS
MO
Enumeration date
04/07/2015
Last updated
06/20/2018
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