MEDICARE: MARK JEFFREY MASLAN 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
1	207Y00000X	Otolaryngology Physician	04-21348	KS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073576302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK JEFFREY MASLAN MD

Provider Business Mailing Address
First Line	:	5520 COLLEGE BLVD
Second Line	:	SUITE 350
City	:	OVERLAND PARK
State	:	KS
Zip	:	66211-1630
Country	:	US
Telephone Number	:	913-663-5100
Fax Number	:	913-663-3354

Provider Business Practice Location Address
First Line	:	5520 COLLEGE BLVD
Second Line	:	SUITE 350
City	:	OVERLAND PARK
State	:	KS
Zip	:	66211-1630
Country	:	US
Telephone Number	:	913-663-5100
Fax Number	:	913-663-3354

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2006
Last Update Date	:	11/12/2020

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