Organization
MID AMERICA INFECTIOUS DISEASE CONSULTANTS PC
Active
Organization
MID AMERICA INFECTIOUS DISEASE CONSULTANTS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CISCO SHERMAN (OFFICE MANAGER)
(816) 561-8125
Entity
Organization
Contact information
Practice address
3215 MAIN ST STE 100B, KANSAS CITY, MO 64111-1946
(816) 561-2433
(816) 931-8721
Mailing address
3215 MAIN ST STE 100B, KANSAS CITY, MO 64111-1946
(816) 561-2433
(816) 931-8721
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
111192
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
440003964
RAILROAD MEDICARE
—
05
—
506075704
—
MO
Enumeration date
09/16/2006
Last updated
07/21/2016
Update your record
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