Healthcare Provider Details

I. General information

NPI: 1376748863
Provider Name (Legal Business Name): MIDWEST OCCUPATIONAL MEDICINE, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3037 MAIN ST SUITE 201
KANSAS CITY MO
64108-3357
US

IV. Provider business mailing address

3037 MAIN ST SUITE 201
KANSAS CITY MO
64108-3357
US

V. Phone/Fax

Practice location:
  • Phone: 816-561-3480
  • Fax: 816-561-4043
Mailing address:
  • Phone: 816-561-3480
  • Fax: 816-561-4043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARY ELIZABETH BROTHERS
Title or Position: OWNER
Credential: MD
Phone: 816-561-3480