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Organization

MIDWEST PEDIATRIC SPECIALISTS P A

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MAKALI R MICKELSON (OFFICE MANAGER)
(913) 310-0482
Entity
Organization

Contact information

Practice address
10550 QUIVIRA RD STE 520, OVERLAND PARK, KS 66215-2307
(913) 310-0482
(913) 894-1330
Mailing address
10550 QUIVIRA RD STE 520, OVERLAND PARK, KS 66215-2307
(913) 310-0482

Taxonomy

Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
2080P0205X
Pediatric Endocrinology Physician
2080P0206X
Pediatric Gastroenterology Physician
Primary

Other

Enumeration date
12/01/2020
Last updated
08/23/2024
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