Healthcare Provider Details

I. General information

NPI: 1942257829
Provider Name (Legal Business Name): LANNY J ROSENWASSER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 HOLMES ST
KANSAS CITY MO
64108-2640
US

IV. Provider business mailing address

2310 HOLMES ST STE 800
KANSAS CITY MO
64108-2634
US

V. Phone/Fax

Practice location:
  • Phone: 816-404-1000
  • Fax:
Mailing address:
  • Phone: 816-218-2500
  • Fax: 816-421-7379

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number2006012251
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: