MEDICARE: DR. BRUCE H SALVAGGIO 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	207R00000X	Internal Medicine Physician	R1A61	MO
2	207R00000X	Internal Medicine Physician	04-33483	KS

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	:	1558341347
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRUCE H SALVAGGIO M.D.

Provider Business Mailing Address
First Line	:	2330 SHAWNEE MISSION PARKWAY
Second Line	:	MEDICAL ADMINISTRATIVE SERVICES OF KU STE. 312
City	:	WESTWOOD
State	:	KS
Zip	:	66205-0000
Country	:	US
Telephone Number	:	913-945-5614
Fax Number	:	913-945-5617

Provider Business Practice Location Address
First Line	:	10787 NALL AVE
Second Line	:	STE. 310
City	:	OVERLAND PARK
State	:	KS
Zip	:	66211-0000
Country	:	US
Telephone Number	:	913-945-6900
Fax Number	:	913-945-6970

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

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	06/16/2009

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