Healthcare Provider Details

I. General information

NPI: 1730170648
Provider Name (Legal Business Name): ERNEST A CATTANEO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 10/31/2005
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5701 W 119TH ST SUITE 330
OVERLAND PARK KS
66209-3722
US

IV. Provider business mailing address

6420 PROSPECT AVENUE SUITE T101
KANSAS CITY MO
64132-1186
US

V. Phone/Fax

Practice location:
  • Phone: 913-451-8500
  • Fax: 913-451-1754
Mailing address:
  • Phone: 816-363-4100
  • Fax: 816-363-8201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR4286
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number04-13506
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: