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General NPI Number Information
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NPI Number | 1790155158
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Entity Type | Organization
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Legal Business Name | SHERIDAN EMERGENCY PHYSICIAN SERVICES OF KANSAS, PA
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Dates
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Enumeration Date | 09/29/2015
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Last Update Date | 01/14/2016
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Provider Practice Location Address
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Address Line | 8929 PARALLEL PKWY
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City | KANSAS CITY
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State | KS
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Zip | 66112-1689
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Country | US
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Telephone | 913-596-4862
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 453548
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City | SUNRISE
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State | FL
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Zip | 33345-3548
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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 | PRESIDENT
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Name | PAUL A ANDRULONIS
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Credential | MD
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Telephone | 954-838-2371
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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