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General NPI Number Information
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NPI Number | 1659545952
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Entity Type | Organization
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Legal Business Name | MOHAMMAD GHASSEMI MD PA
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Dates
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Enumeration Date | 04/17/2008
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Last Update Date | 11/19/2008
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Provider Practice Location Address
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Address Line | 667 SOUTH 55TH ST
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City | KANSAS CITY
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State | KS
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Zip | 66106-1303
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Country | US
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Telephone | 913-287-8900
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Fax |
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Provider Business Mailing Address
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Address Line | 667 S 55TH ST
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City | KANSAS CITY
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State | KS
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Zip | 66106-1303
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Country | US
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Telephone | 913-287-8900
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Fax | 913-287-6218
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Authorized Official
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Title or Position | OWNER
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Name | DR. MOHAMMAD GHASSEMI
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Credential | MD
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Telephone | 913-287-8900
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 0425500
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License Number State | KS
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