Healthcare Provider Details

I. General information

NPI: 1316994841
Provider Name (Legal Business Name): REPRODUCTIVE ENDOCRINE-INFERTILITY CARE, P.A.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1206 NE WINDSOR DR
LEES SUMMIT MO
64086-5594
US

IV. Provider business mailing address

1206 NE WINDSOR DR
LEES SUMMIT MO
64086-5594
US

V. Phone/Fax

Practice location:
  • Phone: 816-246-7665
  • Fax: 816-554-6677
Mailing address:
  • Phone: 816-246-7665
  • Fax: 816-554-6677

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License NumberR6H60
License Number StateMO

VIII. Authorized Official

Name: DR. NEZAAM M. ZAMAH
Title or Position: DIRECTOR / OWNER
Credential: M.D.
Phone: 816-246-7665