Healthcare Provider Details

I. General information

NPI: 1851651285
Provider Name (Legal Business Name): PUTUL MURARKA ALLEN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2012
Last Update Date: 05/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1004 CARONDELET DR STE 310
KANSAS CITY MO
64114-4801
US

IV. Provider business mailing address

1004 CARONDELET DR STE 310
KANSAS CITY MO
64114-4801
US

V. Phone/Fax

Practice location:
  • Phone: 816-942-5437
  • Fax: 816-942-4830
Mailing address:
  • Phone: 816-942-5437
  • Fax: 816-942-4830

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number2009032904
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: