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NPI Code Detail

MEDICARE: SHAFAQ MANSOOR MD

MEDICARE: SHAFAQ MANSOOR 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
12084E0001XEpilepsy Physician04-51022KS

General Provider Information

NPI Number : 1679151443
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHAFAQ MANSOOR MD
Provider Business Mailing Address
First Line : 3901 RAINBOW BLVD
Second Line :
City : KANSAS CITY
State : KS
Zip : 66160-8500
Country : US
Telephone Number : 913-588-6970
Fax Number :
Provider Business Practice Location Address
First Line : 3901 RAINBOW BLVD
Second Line :
City : KANSAS CITY
State : KS
Zip : 66160-8500
Country : US
Telephone Number : 913-588-6970
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2021
Last Update Date : 07/01/2025

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