MEDICARE: NORTHLAND SURGICAL ASSOCIATES, P.C.

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	208600000X	Surgery Physician

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	:	1558459149
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHLAND SURGICAL ASSOCIATES, P.C.

Provider Business Mailing Address
First Line	:	2750 CLAY EDWARDS DR
Second Line	:	SUITE 404
City	:	NORTH KANSAS CITY
State	:	MO
Zip	:	64116-3258
Country	:	US
Telephone Number	:	816-472-9595
Fax Number	:	816-472-0038

Provider Business Practice Location Address
First Line	:	2750 CLAY EDWARDS DR
Second Line	:	SUITE 404
City	:	NORTH KANSAS CITY
State	:	MO
Zip	:	64116-3258
Country	:	US
Telephone Number	:	816-472-9595
Fax Number	:	816-472-0038

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MARK EPSTEIN
Credential	:	M.D.
Telephone Number	:	816-472-9595

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	06/04/2010

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Practice Location Address:

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