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General NPI Number Information
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NPI Number | 1699342147
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Entity Type | Organization
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Legal Business Name | BLUE VALLEY ENDOCRINOLOGY, P.A.
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Dates
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Enumeration Date | 06/04/2021
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Last Update Date | 06/10/2021
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Provider Practice Location Address
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Address Line | 10000 COLLEGE BLVD
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City | OVERLAND PARK
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State | KS
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Zip | 66210-1435
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Country | US
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Telephone | 913-258-5055
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Fax | 913-258-5057
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Provider Business Mailing Address
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Address Line | 10000 COLLEGE BLVD
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City | OVERLAND PARK
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State | KS
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Zip | 66210-1435
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MINI ABRAHAM
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Credential | MD
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Telephone | 913-258-5055
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State |
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