Healthcare Provider Details

I. General information

NPI: 1952412231
Provider Name (Legal Business Name): METROPOLITAN PULMONARY AND SLEEP MEDICINE PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 09/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 NE TUDOR RD
LEES SUMMIT MO
64086-5696
US

IV. Provider business mailing address

290 NE TUDOR RD
LEES SUMMIT MO
64086-5696
US

V. Phone/Fax

Practice location:
  • Phone: 816-524-5522
  • Fax: 816-524-4798
Mailing address:
  • Phone: 816-524-5522
  • Fax: 816-524-4798

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: SIDNEY S DEVINS
Title or Position: PRESIDENT
Credential: MD
Phone: 816-524-5522