Organization
GATES HOSPITALISTS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STACEY MICHELLE GATES (BUSINESS MANAGER)
(816) 968-9320
Entity
Organization
Contact information
Practice address
2750 CLAY EDWARDS DR STE 200A, NORTH KANSAS CITY, MO 64116-3237
(816) 968-9320
Mailing address
PO BOX 256, LIBERTY, MO 64069-0256
(816) 968-9320
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
2000174342
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200305270A
—
KS
01
—
33624016
BLUE SHIELD KANSAS CITY
MO
05
—
509340907
—
MO
Enumeration date
07/19/2005
Last updated
03/27/2021
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