Individual
DR. GRACIELLE NICOLE BAHIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O., M.A.
Contact information
Practice address
5808 W 110TH ST, OVERLAND PARK, KS 66211-2504
(913) 696-8000
(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
2080P0206X
Pediatric Gastroenterology Physician
Primary
05-43291
KS
Other
Enumeration date
06/05/2013
Last updated
06/09/2020
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