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NPI Code Detail

MEDICARE: DR. BONNIE LEE BIRCHANSKY MD

MEDICARE: DR. BONNIE LEE BIRCHANSKY 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
12084P0804XChild & Adolescent Psychiatry PhysicianR9N47MO

General Provider Information

NPI Number : 1831160241
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BONNIE LEE BIRCHANSKY MD
Provider Business Mailing Address
First Line : 902 EDMOND ST
Second Line : SUITE 203
City : SAINT JOSEPH
State : MO
Zip : 64501-2702
Country : US
Telephone Number : 816-364-4300
Fax Number : 816-279-8148
Provider Business Practice Location Address
First Line : 902 EDMOND ST
Second Line : SUITE 203
City : SAINT JOSEPH
State : MO
Zip : 64501-2702
Country : US
Telephone Number : 816-364-4300
Fax Number : 816-279-8148
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2006
Last Update Date : 07/09/2007

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