MEDICARE: BRENT WILLIAM GINSBERG MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician	R9326	MO
2	207RG0100X	Gastroenterology Physician	17236	KS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	100003019	OTHER		RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1811994239
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRENT WILLIAM GINSBERG MD

Provider Business Mailing Address
First Line	:	2330 E MEYER BLVD
Second Line	:	STE 301
City	:	KANSAS CITY
State	:	MO
Zip	:	64132-4185
Country	:	US
Telephone Number	:	816-333-5424
Fax Number	:	816-822-0870

Provider Business Practice Location Address
First Line	:	2330 E MEYER BLVD
Second Line	:	STE 301
City	:	KANSAS CITY
State	:	MO
Zip	:	64132-4185
Country	:	US
Telephone Number	:	816-333-5424
Fax Number	:	816-822-0870

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	05/13/2015

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