Healthcare Provider Details

I. General information

NPI: 1316939218
Provider Name (Legal Business Name): SAMIN AKHTAR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/17/2005
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 CLAY EDWARDS DR STE 400
NORTH KANSAS CITY MO
64116-3270
US

IV. Provider business mailing address

2700 CLAY EDWARDS DR STE 240
NORTH KANSAS CITY MO
64116-3254
US

V. Phone/Fax

Practice location:
  • Phone: 816-421-4240
  • Fax: 816-421-5015
Mailing address:
  • Phone: 816-691-5287
  • Fax: 816-346-7690

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2013038708
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMD425177
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: