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NPI Code Detail

MEDICARE: CHILDREN'S MERCY-PEDIATRIC CARE NORTH, INC

MEDICARE: CHILDREN'S MERCY-PEDIATRIC CARE NORTH, INC
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 Physician

General Provider Information

NPI Number : 1164969952
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILDREN'S MERCY-PEDIATRIC CARE NORTH, INC
Provider Business Mailing Address
First Line : 2401 GILLHAM RD
Second Line : PROVIDER ENROLLMENT DEPT
City : KANSAS CITY
State : MO
Zip : 64108-4619
Country : US
Telephone Number :
Fax Number :
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 :
Authorized Official
Title or Position : VICE PRESIDENT
Name : ROBERT D FINUF II
Credential :
Telephone Number : 816-559-9370
Provider Enumeration Date : 01/31/2017
Last Update Date : 03/06/2017

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