Individual
DR. PHOLAPHAT CHARLIE INBORIBOON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2301 HOLMES ST, KANSAS CITY, MO 64108-2640
(816) 404-1536
Mailing address
2310 HOLMES ST, STE 800, KANSAS CITY, MO 64108-2602
(816) 218-2500
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036115754
IL
207P00000X
Emergency Medicine Physician
2012013852
MO
207P00000X
Emergency Medicine Physician
239506
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02775895
—
NY
Enumeration date
08/30/2006
Last updated
03/06/2025
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