MEDICARE: DR. JOEL DOUGLAS MERMIS MD

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	207RP1001X	Pulmonary Disease Physician	0432603	KS

General Provider Information

NPI Number	:	1396814430
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOEL DOUGLAS MERMIS MD

Provider Business Mailing Address
First Line	:	6130 OAK ST
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64113-2233
Country	:	US
Telephone Number	:	816-813-7373
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 RAINBOW BLVD
Second Line	:
City	:	KANSAS CITY
State	:	KS
Zip	:	66160-3033
Country	:	US
Telephone Number	:	913-588-6046
Fax Number	:

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

Provider Enumeration Date	:	11/06/2006
Last Update Date	:	03/26/2010

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