Organization
ADVANCED CARDIOVASCULAR SPECIALISTS I,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRINA REAVIS (OFFICE MANAGER)
(816) 415-1900
Entity
Organization
Contact information
Practice address
1530 N CHURCH RD, LIBERTY, MO 64068-7129
(816) 415-1900
(816) 415-1800
Mailing address
1530 N CHURCH RD, LIBERTY, MO 64068-7129
(816) 415-1900
(816) 415-1800
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25313018
BCBS OF KANSAS CITY GROUP
MO
Enumeration date
01/29/2007
Last updated
08/19/2009
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