Healthcare Provider Details

I. General information

NPI: 1942299268
Provider Name (Legal Business Name): MIDWEST NEPHROLOGY CONSULTANTS PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/19/2005
Last Update Date: 10/29/2020
Certification Date: 10/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2340 E MEYER BLVD STE 480
KANSAS CITY MO
64132-1116
US

IV. Provider business mailing address

2340 E MEYER BLVD STE 480
KANSAS CITY MO
64132-1116
US

V. Phone/Fax

Practice location:
  • Phone: 816-276-1700
  • Fax: 816-276-1703
Mailing address:
  • Phone: 816-276-1770
  • Fax: 816-276-1703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number State

VIII. Authorized Official

Name: SYD L STEVENS
Title or Position: PRACTICE ADMINISTRATOR
Credential:
Phone: 816-276-1770