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General NPI Number Information
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NPI Number | 1588119747
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Entity Type | Organization
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Legal Business Name | MIACARE MEDICAL SERVICES, LLC
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Dates
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Enumeration Date | 08/17/2016
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Last Update Date | 08/17/2016
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Provider Practice Location Address
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Address Line | 3161 N ROCK RD SUITE A
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City | WICHITA
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State | KS
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Zip | 67226-1452
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Country | US
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Telephone | 316-554-4888
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Fax | 316-440-2713
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Provider Business Mailing Address
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Address Line | 3161 N ROCK RD SUITE A
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City | WICHITA
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State | KS
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Zip | 67226-1452
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Country | US
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Telephone | 316-554-4888
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Fax | 316-440-2713
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MAZEN H. SHAHEEN
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Credential | M.D.
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Telephone | 316-554-4888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number |
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State | KS
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