Organization
NORTHLAND EAR NOSE & THROAT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW E BEUERLEIN MD (PRESIDENT)
(816) 781-1001
Entity
Organization
Contact information
Practice address
2521 GLENN HENDREN DRIVE, SUITE 104, LIBERTY, MO 64068-3388
(816) 781-1001
(816) 792-0408
Mailing address
2521 GLENN HENDREN DRIVE, SUITE 104, LIBERTY, MO 64068-3388
(816) 781-1001
(816) 792-0408
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27835011
BLUE CROSS BLUE SHIELD
MO
01
—
NENT627212
BLUE CROSS BLUE SHIELD
KS
Enumeration date
06/27/2006
Last updated
08/22/2020
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