Individual
DR. HODA TAVALALI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2800 CLAY EDWARDS DR, KANSAS CITY, MO 64116-3220
(816) 691-2000
Mailing address
PO BOX 11157, KANSAS CITY, MO 64119-0157
(816) 346-7220
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2011009932
MO
390200000X
Student in an Organized Health Care Education/Training Program
—
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1851564033
—
MO
Enumeration date
04/08/2008
Last updated
10/26/2017
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