Healthcare Provider Details

I. General information

NPI: 1750324786
Provider Name (Legal Business Name): GEORGE A SALEH D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/14/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 NE 54TH ST SUITE 111
KANSAS CITY MO
64118-4361
US

IV. Provider business mailing address

200 NE 54TH ST SUITE 111
KANSAS CITY MO
64118-4361
US

V. Phone/Fax

Practice location:
  • Phone: 816-455-7400
  • Fax: 816-455-7404
Mailing address:
  • Phone: 816-455-7400
  • Fax: 816-455-7404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberR8749
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: