Healthcare Provider Details

I. General information

NPI: 1912998329
Provider Name (Legal Business Name): DANIEL MURILLO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2005
Last Update Date: 08/16/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6400 PROSPECT AVE SUITE 328
KANSAS CITY MO
64132-1100
US

IV. Provider business mailing address

6400 PROSPECT AVE SUITE 328
KANSAS CITY MO
64132-1100
US

V. Phone/Fax

Practice location:
  • Phone: 816-822-8257
  • Fax: 816-822-8259
Mailing address:
  • Phone: 816-822-8257
  • Fax: 816-822-8259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204F00000X
TaxonomyTransplant Surgery Physician
License Number2003027453
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: