Healthcare Provider Details

I. General information

NPI: 1851338735
Provider Name (Legal Business Name): ADVIVUM ANESTHESIOLOGY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2006
Last Update Date: 07/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5830 NW BARRY RD
KANSAS CITY MO
64154-2778
US

IV. Provider business mailing address

5830 NW BARRY RD
KANSAS CITY MO
64154-2778
US

V. Phone/Fax

Practice location:
  • Phone: 816-880-6440
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: ROBERT MORRISON
Title or Position: MD
Credential:
Phone: 816-880-6440