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General NPI Number Information
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NPI Number | 1790362507
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Entity Type | Individual
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Provider Name | KERRY CENIZA MIAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 4000 CAMBRIDGE ST
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City | KANSAS CITY
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State | KS
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Zip | 66160-8500
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Country | US
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Telephone | 913-588-1227
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Fax |
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Provider Business Mailing Address
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Address Line | 3901 RAINBOW BLVD # MS 1046
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City | KANSAS CITY
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State | KS
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Zip | 66160-8500
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Country | US
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Telephone | 913-588-6896
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Fax |
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 2025014851
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 04-51416
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License Number State | KS
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