MEDICARE: MD ELECTRODIAGNOSIS INC. P C

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	2084N0400X	Neurology Physician

General Provider Information

NPI Number	:	1114020617
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MD ELECTRODIAGNOSIS INC. P C

Provider Business Mailing Address
First Line	:	2330 E MEYER BLVD STE T107
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64132-1140
Country	:	US
Telephone Number	:	816-361-8684
Fax Number	:

Provider Business Practice Location Address
First Line	:	2330 E MEYER BLVD STE T107
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64132-1140
Country	:	US
Telephone Number	:	816-361-8684
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JOHN J SAND
Credential	:
Telephone Number	:	816-361-8684

Provider Enumeration Date	:	09/07/2006
Last Update Date	:	05/27/2024

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