Organization
ST. JOSEPH MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN CLEARY (VICE PRESIDENT)
(816) 943-2819
Entity
Organization
Contact information
Practice address
1000 CARONDELET DR, KANSAS CITY, MO 64114-4673
(816) 941-7727
Mailing address
1000 CARONDELET DR, KANSAS CITY, MO 64114-4673
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100099610C
KANSAS MEDICAID
KS
01
—
34275011
BLUE CROSS BLUE SHIELD
MO
01
—
506229103
MISSOURI MEDICAID
MO
Enumeration date
06/05/2006
Last updated
03/13/2009
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