Healthcare Provider Details

I. General information

NPI: 1659571966
Provider Name (Legal Business Name): SHELDON FLEISHMAN D.P.M., P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 10/31/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10701 NALL AVE SUITE 120
OVERLAND PARK KS
66211-1231
US

IV. Provider business mailing address

1050 S OUTER RD
BLUE SPRINGS MO
64015-3064
US

V. Phone/Fax

Practice location:
  • Phone: 913-381-5515
  • Fax: 913-381-5514
Mailing address:
  • Phone: 816-228-9393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number12-00109
License Number StateKS

VIII. Authorized Official

Name: DR. SHELDON FLEISHMAN
Title or Position: OWNER
Credential: DPM
Phone: 913-381-5515