Healthcare Provider Details

I. General information

NPI: 1124255021
Provider Name (Legal Business Name): MICHAEL SEUNG RHEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2009
Last Update Date: 03/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 GLENN HENDREN DR
LIBERTY MO
64068-9625
US

IV. Provider business mailing address

PO BOX 219672
KANSAS CITY MO
64121-9672
US

V. Phone/Fax

Practice location:
  • Phone: 816-415-3420
  • Fax: 816-781-3517
Mailing address:
  • Phone: 816-407-4200
  • Fax: 816-407-2362

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number2014009349
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: