Healthcare Provider Details

I. General information

NPI: 1164889028
Provider Name (Legal Business Name): TARIQ MUSA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/24/2016
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 CARONDELET DR STE 300
KANSAS CITY MO
64114-4858
US

IV. Provider business mailing address

1701 E 23RD AVE
HUTCHINSON KS
67502-1105
US

V. Phone/Fax

Practice location:
  • Phone: 816-942-4500
  • Fax: 816-943-4504
Mailing address:
  • Phone: 620-513-4800
  • Fax: 620-513-4801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberU1611
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberU1611
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number2023038917
License Number StateMO
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number04-41586
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: