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General NPI Number Information
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NPI Number | 1851340095
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Entity Type | Individual
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Provider Name | MICHAEL L MAIN MD
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Gender | Male
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Dates
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Enumeration Date | 05/06/2006
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Last Update Date | 09/08/2020
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Provider Practice Location Address
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Address Line | 4330 WORNALL RD SUITE 2000
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City | KANSAS CITY
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State | MO
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Zip | 64111-5939
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Country | US
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Telephone | 816-931-1883
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Fax | 816-756-3645
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Provider Business Mailing Address
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Address Line | 901 E 104TH ST MAILSTOP 400S
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City | KANSAS CITY
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State | MO
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Zip | 64131
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Country | US
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Telephone | 816-502-7117
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Fax | 816-932-9670
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 116372
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License Number State | MO
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