Healthcare Provider Details

I. General information

NPI: 1891310132
Provider Name (Legal Business Name): ANEEZA IRFAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/12/2020
Last Update Date: 09/11/2020
Certification Date: 09/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

TRUMAN MEDICAL CENTER 2301 HOLMES, DEPT. OF PATHOLOGY
KANSAS CITY MO
64108
US

IV. Provider business mailing address

UNIVERSITY OF MISSOURI-KANSAS CITY SCHOOL OF MEDICINE 2411 HOLMES, M2-301, GRADUATE MEDICAL EDUCATION
KANSAS CITY MO
64108
US

V. Phone/Fax

Practice location:
  • Phone: 816-404-4175
  • Fax: 816-404-0003
Mailing address:
  • Phone: 816-235-6627
  • Fax: 816-235-6629

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number2020019724
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: