Individual
MICHAEL P DAVOREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
20375 W 151ST ST, SUITE 463, OLATHE, KS 66061-7218
(913) 782-8577
(913) 782-2616
Mailing address
20375 W 151ST ST, SUITE 463, OLATHE, KS 66061-7218
(913) 782-8577
(913) 782-2616
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
0425580
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100421010C
—
KS
01
—
32810013
BCBS OF KANSAS CITY
—
01
—
7357335
AETNA
—
01
—
P00067790
RAILROAD MEDICARE
—
Enumeration date
01/12/2007
Last updated
12/08/2014
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