Individual
DR. JOSEPH THEODORE CERNICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3101 BROADWAY BLVD, KANSAS CITY, MO 64111-2659
(816) 302-3700
(816) 302-9939
Mailing address
2401 GILLHAM RD, ATTN PROVIDER ENROLLMENT DEPT, KANSAS CITY, MO 64108-4619
(816) 701-5200
(816) 302-9939
Taxonomy
Speciality
Code
Description
License number
State
2080P0205X
Pediatric Endocrinology Physician
04-29903
KS
2080P0205X
Pediatric Endocrinology Physician
Primary
2003000631
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209246305
—
MO
Enumeration date
05/11/2006
Last updated
11/25/2025
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