Healthcare Provider Details

I. General information

NPI: 1669409942
Provider Name (Legal Business Name): SHERMAN S SHE MD ( IN CHINA )
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7611 STATE LINE RD STE 268
KANSAS CITY MO
64114-1670
US

IV. Provider business mailing address

7611 STATE LINE RD STE 268
KANSAS CITY MO
64114-1670
US

V. Phone/Fax

Practice location:
  • Phone: 816-361-4798
  • Fax:
Mailing address:
  • Phone: 816-361-4798
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number2002010027
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: