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Individual

ROBERT EVANGELIDIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9100 W 74TH ST, OVERLAND PARK, KS 66204-4004
(913) 676-2000
Mailing address
10540 MARTY ST, SUITE 100, OVERLAND PARK, KS 66212-2551
(913) 660-1616

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
04-32560
KS
207R00000X
Internal Medicine Physician
2007014753
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
38151019
BLUE SHIELD KANSAS CITY
MO
01
7610908
AETNA
MO
Enumeration date
05/02/2007
Last updated
11/03/2011
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