Individual
DANIEL P BORTNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11550 GRANADA ST, LEAWOOD, KS 66211-1453
(913) 754-4939
(913) 663-2411
Mailing address
11550 GRANADA ST, LEAWOOD, KS 66211-1453
(913) 754-4939
(913) 663-2411
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
0422406
KS
208200000X
Plastic Surgery Physician
105608
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P73000009
MEDICARE KS
KS
01
—
P73A00011
MEDICARE MO
MO
Enumeration date
05/17/2006
Last updated
08/04/2017
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