Healthcare Provider Details

I. General information

NPI: 1689662637
Provider Name (Legal Business Name): ABIYE YVONNE OKAH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/12/2005
Last Update Date: 04/13/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3801 BLUE PKWY
KANSAS CITY MO
64130-2807
US

IV. Provider business mailing address

3449 W 143RD TER
LEAWOOD KS
66224-3654
US

V. Phone/Fax

Practice location:
  • Phone: 816-923-5800
  • Fax: 816-922-7686
Mailing address:
  • Phone: 913-402-0325
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2000169531
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: