MEDICARE: DR. JOHN E PAWSAT M.D.

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	174400000X	Specialist	R4016	MO

General Provider Information

NPI Number	:	1225231970
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN E PAWSAT M.D.

Provider Business Mailing Address
First Line	:	4320 WORNALL RD STE 432
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3235
Country	:	US
Telephone Number	:	816-931-2105
Fax Number	:	816-931-0509

Provider Business Practice Location Address
First Line	:	4320 WORNALL RD STE 432
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-3235
Country	:	US
Telephone Number	:	816-931-2105
Fax Number	:	816-931-0509

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

Provider Enumeration Date	:	06/08/2007
Last Update Date	:	07/08/2007

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