Healthcare Provider Details

I. General information

NPI: 1760767529
Provider Name (Legal Business Name): VISITING PROVIDERS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2011
Last Update Date: 10/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4963 NE GOODVIEW CIR SUITE C
LEES SUMMIT MO
64064-1998
US

IV. Provider business mailing address

4963 NE GOODVIEW CIR SUITE C
LEES SUMMIT MO
64064-1998
US

V. Phone/Fax

Practice location:
  • Phone: 816-809-6850
  • Fax:
Mailing address:
  • Phone: 816-809-6850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateMO

VIII. Authorized Official

Name: MR. MOHAMMAD ABID MALIK
Title or Position: OWNER
Credential:
Phone: 816-809-6850