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General NPI Number Information
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NPI Number | 1235274127
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Entity Type | Organization
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Legal Business Name | VASCULAR SURGERY ASSOCIATES, P.C.
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Dates
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Enumeration Date | 02/20/2007
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Last Update Date | 06/24/2010
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Provider Practice Location Address
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Address Line | 2521 GLENN HENDREN DR SUITE 112
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City | LIBERTY
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State | MO
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Zip | 64068-3388
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Country | US
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Telephone | 816-781-5006
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Fax | 816-781-9212
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Provider Business Mailing Address
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Address Line | 2521 GLENN HENDREN DR SUITE 112
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City | LIBERTY
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State | MO
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Zip | 64068-3388
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Country | US
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Telephone | 816-781-5006
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Fax | 816-781-9212
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MIKE L. WALDSCHMDIT
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Credential | M.D.
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Telephone | 816-781-5006
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number |
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License Number State |
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