Healthcare Provider Details

I. General information

NPI: 1235128703
Provider Name (Legal Business Name): MARIA C PAILLAMAN-BELLO MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARIA C PAILLAMAN MD

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 09/17/2021
Certification Date: 09/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6345 LONG AVE
SHAWNEE KS
66216-2504
US

IV. Provider business mailing address

6345 LONG AVE
SHAWNEE KS
66216-2504
US

V. Phone/Fax

Practice location:
  • Phone: 913-631-6400
  • Fax: 913-631-6868
Mailing address:
  • Phone: 913-631-6400
  • Fax: 913-631-6868

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number01040775A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number04-40539
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: