Individual
FREDERICK SCOTT DATTEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1004 CARONDELET DR, SUITE 330, KANSAS CITY, MO 64114-4802
(816) 941-6400
(816) 941-6404
Mailing address
1004 CARONDELET DR, SUITE 330, KANSAS CITY, MO 64114-4802
(816) 941-6400
(816) 941-6404
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
100376
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100281970C
—
KS
05
—
208124610
—
MO
Enumeration date
09/26/2006
Last updated
07/08/2007
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