Individual
KASRA KERAMATIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3801 S NATIONAL AVE STE 900, SPRINGFIELD, MO 65807-5210
(417) 875-3000
Mailing address
PO BOX 802843, KANSAS CITY, MO 64180-2843
Taxonomy
Speciality
Code
Description
License number
State
2084E0001X
Epilepsy Physician
MD470017
PA
2084N0400X
Neurology Physician
Primary
2021047063
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200111914
—
MO
Enumeration date
04/13/2016
Last updated
09/14/2022
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