Healthcare Provider Details

I. General information

NPI: 1265128763
Provider Name (Legal Business Name): MARSHA MEDICAL GROUP OF KANSAS, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2023
Last Update Date: 04/17/2023
Certification Date: 04/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2101 SW 21ST ST
TOPEKA KS
66604-3174
US

IV. Provider business mailing address

1 BOSTON PL STE 2600
BOSTON MA
02108-4420
US

V. Phone/Fax

Practice location:
  • Phone: 617-958-5697
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ADAM SASSO
Title or Position: PRESIDENT
Credential: MD
Phone: 631-327-1710