Individual
MICHAEL DAVID PURICELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5808 W 110TH ST, OVERLAND PARK, KS 66211-2504
(913) 696-8000
Mailing address
2401 GILLHAM RD, KANSAS CITY, MO 64108-4619
(816) 234-3000
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
73082-20
WI
207YP0228X
Pediatric Otolaryngology Physician
04-49773
KS
207YP0228X
Pediatric Otolaryngology Physician
Primary
2024039721
MO
207YX0901X
Otology & Neurotology Physician
04-49773
KS
207YX0901X
Otology & Neurotology Physician
2024039721
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04-49773
KANSAS BOARD OF HEALTH ARTS
KS
01
—
2024039721
MO BOARD OF HEALING ARTS
MO
Enumeration date
06/01/2012
Last updated
10/02/2024
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