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General NPI Number Information
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NPI Number | 1710955109
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Entity Type | Individual
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Provider Name | SUSANA CHAVEZ-BUENO MD
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Gender | Female
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 08/22/2016
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Provider Practice Location Address
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Address Line | 2401 GILLHAM RD
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City | KANSAS CITY
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State | MO
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Zip | 64108-4619
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Country | US
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Telephone | 816-234-3000
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Fax | 816-302-9939
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Provider Business Mailing Address
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Address Line | 2401 GILLHAM RD PROVIDER ENROLLMENT
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City | KANSAS CITY
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State | MO
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Zip | 64108-4619
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Country | US
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Telephone | 816-701-5200
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Fax | 816-302-9939
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 21673
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | 21673
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License Number State | OK
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Taxonomy #3
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | 04-39280
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License Number State | KS
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Taxonomy #4
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Taxonomy Code | 2080P0208X
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Taxonomy Name | Pediatric Infectious Diseases Physician
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License Number | 2016025643
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License Number State | MO
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Taxonomy #5
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2016025643
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License Number State | MO
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Taxonomy #6
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 04-39280
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License Number State | KS
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