Individual
COREY MICHAEL WHITESIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.-C
Contact information
Practice address
2790 CLAY EDWARDS DR, STE 600, KANSAS CITY, MO 64116-3276
(816) 561-3003
(816) 889-1584
Mailing address
2790 CLAY EDWARDS DR, STE 600, KANSAS CITY, MO 64116-3276
(816) 561-3003
(816) 889-1584
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2013013231
MO
363AS0400X
Surgical Physician Assistant
2013013231
MO
Other
Enumeration date
05/03/2013
Last updated
05/03/2013
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