MEDICARE: DR. PASCAL NYACHOWE 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	2086S0127X	Trauma Surgery Physician	2005039880	MO

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

General Provider Information

NPI Number	:	1285684167
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. PASCAL NYACHOWE M.D.

Provider Business Mailing Address
First Line	:	901 E 104TH ST
Second Line	:	MAILSTOP 400
City	:	KANSAS CITY
State	:	MO
Zip	:	64131
Country	:	US
Telephone Number	:	816-502-8755
Fax Number	:	816-932-9670

Provider Business Practice Location Address
First Line	:	4320 WORNALL RD STE 5320
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64111-5941
Country	:	US
Telephone Number	:	816-932-2836
Fax Number	:	816-932-9868

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

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	11/15/2017

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