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Organization

A4ME, PROFESSIONAL ASSOCIATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MANIZA EHTESHAM MD (CERTIFYING OFFICER)
(913) 485-4139
Entity
Organization

Contact information

Practice address
9100 W 74TH ST, SHAWNEE MISSION, KS 66204-4004
(913) 485-4139
Mailing address
15400 LARSEN ST, OVERLAND PARK, KS 66221-6807

Taxonomy

Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
436887
KS
261QS1200X
Sleep Disorder Diagnostic Clinic/Center

Other

Enumeration date
02/27/2014
Last updated
02/27/2014
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