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Individual

MICHAEL WILLIAM PAVLISIN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5325 FARAON ST, SAINT JOSEPH, MO 64506-3488
(816) 271-6000
Mailing address
6304 N WAYNE AVE, GLADSTONE, MO 64118-4953
(314) 620-8941

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2022019864
MO
208M00000X
Hospitalist Physician
Primary
2022019864
MO

Other

Enumeration date
02/08/2017
Last updated
07/25/2025
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