Individual
DR. CARRIE EILEEN BASTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2700 CLAY EDWARDS DR STE 240, NORTH KANSAS CITY, MO 64116-3254
(816) 691-2021
(816) 346-7690
Mailing address
2700 CLAY EDWARDS DR STE 240, NORTH KANSAS CITY, MO 64116-3254
(816) 691-2021
(816) 346-7690
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
2009014085
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1285753228
—
MO
05
—
200608160B
—
KS
01
—
P00835589
RR MEDICARE
MO
Enumeration date
03/29/2007
Last updated
05/11/2020
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