Individual
PETER BASTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6420 PROSPECT AVE, SUITE T411, KANSAS CITY, MO 64132-4147
(816) 363-2500
(816) 363-8741
Mailing address
6420 PROSPECT AVE, SUITE T411, KANSAS CITY, MO 64132-4147
(816) 363-2500
(816) 363-8741
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
01062089
IN
207T00000X
Neurological Surgery Physician
04-32315
KS
207T00000X
Neurological Surgery Physician
Primary
2007010290
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11561915
CAQH
—
Enumeration date
06/29/2006
Last updated
01/25/2022
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