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Individual

DR. ROMAN SUAREZ ENRIQUEZ JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2700 CLAY EDWARDS DR, SUITE 400, NORTH KANSAS CITY, MO 64116-3251
(816) 421-4240
(816) 421-5015
Mailing address
2700 CLAY EDWARDS DR, SUITE 400, NORTH KANSAS CITY, MO 64116-3251
(816) 421-4240
(816) 421-5015

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MDR6760
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08411065
BCBS OF KC INDIVIDUAL #
01
110231295
RAILROAD MEDICARE
05
201218443
MO
Enumeration date
02/03/2006
Last updated
04/20/2017
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