Healthcare Provider Details

I. General information

NPI: 1447784152
Provider Name (Legal Business Name): CHILDREN'S MERCY - CASS COUNTY PEDIATRICS & ADOLESCENTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2017
Last Update Date: 04/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

503 N SCOTT AVE
BELTON MO
64012-1730
US

IV. Provider business mailing address

503 N SCOTT AVE
BELTON MO
64012-1730
US

V. Phone/Fax

Practice location:
  • Phone: 816-322-4769
  • Fax:
Mailing address:
  • Phone: 816-322-4769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT D FINUF II
Title or Position: VICE PRESIDENT
Credential:
Phone: 816-559-9370