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General NPI Number Information
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NPI Number | 1972928935
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Entity Type | Organization
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Legal Business Name | A4ME, PROFESSIONAL ASSOCIATION
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Dates
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Enumeration Date | 02/27/2014
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Last Update Date | 02/27/2014
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Provider Practice Location Address
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Address Line | 9100 W 74TH ST
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City | SHAWNEE MISSION
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State | KS
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Zip | 66204-4004
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Country | US
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Telephone | 913-485-4139
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Fax |
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Provider Business Mailing Address
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Address Line | 15400 LARSEN ST
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City | OVERLAND PARK
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State | KS
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Zip | 66221-6807
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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 | CERTIFYING OFFICER
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Name | MANIZA EHTESHAM
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Credential | MD
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Telephone | 913-485-4139
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 436887
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License Number State | KS
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