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NPI Code Detail

MEDICARE: DR. MAIKO G EBERSOLE-ROBINSON MD MPH

MEDICARE:  DR. MAIKO G EBERSOLE-ROBINSON  MD MPH
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
1207Q00000XFamily Medicine Physician0432451KS
2207Q00000XFamily Medicine Physician2003014839MO

Other Identifiers

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

General Provider Information

NPI Number : 1386611457
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MAIKO G EBERSOLE-ROBINSON MD MPH
Provider Business Mailing Address
First Line : 417 E 37TH ST
Second Line :
City : KANSAS CITY
State : MO
Zip : 64109-2604
Country : US
Telephone Number : 816-268-4295
Fax Number : 816-268-4297
Provider Business Practice Location Address
First Line : 1403 GRAND BLVD
Second Line :
City : KANSAS CITY
State : MO
Zip : 64106-2917
Country : US
Telephone Number : 816-268-4295
Fax Number : 816-268-4297
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/07/2006
Last Update Date : 01/30/2024

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