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General NPI Number Information
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NPI Number | 1639462328
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Entity Type | Individual
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Provider Name | SHERVIN RAZAVIAN MD
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Gender | Male
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Dates
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Enumeration Date | 05/27/2011
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Last Update Date | 09/27/2021
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Provider Practice Location Address
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Address Line | 2100 SE BLUE PKWY
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City | LEES SUMMIT
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State | MO
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Zip | 64063-1007
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Country | US
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Telephone | 816-282-5000
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Fax | 913-428-2951
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Provider Business Mailing Address
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Address Line | 8717 W 110TH ST STE 600
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City | OVERLAND PARK
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State | KS
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Zip | 66210-2126
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Country | US
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Telephone | 913-428-2900
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Fax | 913-428-2951
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 94-07633
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 2015013978
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License Number State | MO
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