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NPI Code Detail

MEDICARE: DR. SHANE MICHAEL STORM MD

MEDICARE: DR. SHANE MICHAEL STORM MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician8862NE
2208000000XPediatrics Physician2023015522MO

General Provider Information

NPI Number : 1043836703
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SHANE MICHAEL STORM MD
Provider Business Mailing Address
First Line : 8781 N PLATTE PURCHASE DR
Second Line :
City : KANSAS CITY
State : MO
Zip : 64155-1829
Country : US
Telephone Number : 816-587-3200
Fax Number : 816-587-7644
Provider Business Practice Location Address
First Line : 8781 N PLATTE PURCHASE DR
Second Line :
City : KANSAS CITY
State : MO
Zip : 64155-1829
Country : US
Telephone Number : 816-587-3200
Fax Number : 816-587-7644
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/18/2020
Last Update Date : 08/13/2024

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